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Use this form to submit your case without doing the online case screening first - you can do the case screening first to submit your facts to the computer's questions and then submit the below also.


 
First Name
Last Name
Email
Phone
Address
City
State
Contact Preference
Date of Arrest mm/dd/yyyy
City Arrested In
State Arrested In
Court Date mm/dd/yyyy
Occupation
Did the officer see you driving?
Was there a valid reason for stopping you?
What was the officer's reason for stopping you?
Facts on the arrest
Ex: Time stopped, time arrested, results of scientific chemical tests.
 
1000 Character limit
 

 


 
 
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