First Name
Middle Name
Last Name
Address
City
State
Zip
Phone
E-mail
Case No.
Court
i.e.
family, probate, etc.
Name of your attorney also firm or note
if pro se (represented yourself, appeared without counsel).
Names of the attorneys of the other
party or note if pro se.
Name of the judge(s)
Sate What your case was about?
Did you have a fair and impartial
hearing, trial, mediation, settlement
If you appeared pro se were you treated
fairly or unfairly?
Did you have a fair opportunity to
speak or give testimony and were you
Did you have a fair opportunity to
present evidence and were you
Was there any law applied to the your
case
and was cited in the
Was the law fairly applied, if not
please explain.
Please specify any other information
pertaining to your case you feel is important
