The Law Offices of Douglas M. Heagler

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Traffic Ticket Information Form

 

For The Law Offices of Douglas M. Heagler to better assist you in handling your traffic ticket, please complete the following information in the "message body" and it will be e-mailed to us. We will contact you within 24 hours of receiving your message.

 

Please Include the Following Information:
 
1.   First, Middle and Last Name
2.   Date of Birth
3.   Driver's License Number
4.   Social Security Number
5.   Current Street Address, City, State and Zip Code
6.   Phone Number
7.   Alternate Phone Number
8.   Traffic Violation Info (charges are on the ticket - for speeding violations please include miles over)
9.   Ticket Number
10.  Date of Ticket
11.  Name of Court
12.  Court Address, City, State and Zip Code
13.  Court Phone Number
14.  Court Date and Time
15.  Any comments that you believe will help in assisting you and your case
 
* First name (required):

* Last name (required):
* E-mail address (required):

Phone number:
* Message (required):

Please submit all requested information above so that we can process your request for a free consultation and fee quote.

The above form is a request for information only. Submitting this form does not create an attorney-client relationship with Douglas M. Heagler, Attorney at Law, or The Law Offices of Douglas M. Heagler. An attorney-client relationship is created only upon acceptance of your case after consultation (via telephone or e-mail) and payment of all attorney's fees and your agreement to pay all fines and court costs in a timely manner.