PLEASE FILL OUT PAGES 1 & 2 OF OUR MUNICIPAL
COURT INTERVIEW FORM AND RETURN TO OUR OFFICE
KENNETH VERCAMMEN & ASSOCIATES, PC
ATTORNEY AT LAW
2053 WOODBRIDGE
AVENUE
EDISON, NJ
08817
PLEASE PRINT 732-572-0500
NAME ____________________________________________________
ADDRESS
_________________________________________________
CITY _______________________ STATE ____ ZIP
______________
CELL #(_____)_________________
PHONE-DAY(____)________________
NIGHT (______)_________________
TODAY'S
DATE ____/_____/_____ E-MAIL
________________________
Referred By:
__________________________________________
If
referred by a person, is this a client or attorney? If you heard about the law office on the Internet,
what search terms did you use?
WHAT
ARE YOU CHARGED WITH (Not the
Summon(s) #) [provide tickets, hearing notice and other important papers to
front desk to be copied]
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________
IMPORTANT INFORMATION
Date of Offense:
__________________ Time: _____
(A.M./P.M.) Your Age _____
Town: ___________________________ (street/location)?____________________
What Happened:
________________________________________________
_____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Write additional details on the back of this page. YOU MUST FILL OUT BOTH PAGES PRIOR TO
SEEING THE ATTORNEY. Mun Ct
Questionnaire rev 10/24/12
Kenneth Vercammen, Esq. Confidential
interview form page 2
Other Persons Arrested or Witnesses: [If
none write none]
______________________ ____________________________
co-defendant/ Witness Name Their Address Phone No.
______________
______________________________________
Name Address Phone No.
3.
Write down everything you said in police presence. What did police say to you?
______________________________________________________________
______________________________________________________________
4. Occupation: _____________ Employer:
_______________ Town: _____________
[Attach your
business card to clipboard.]
Do
you need your driver’s license for work? ____ Distance driven to work: _______
5.
Prior criminal arrests, convictions, PTI,
Conditional Discharge (include description of each charge, date of
conviction, and town conviction for every offense) if none, write none: criminal arrests Town Year
1.____________________________________________________________
2.
___________________________________________________________
3.
___________________________________________________________
6. Prior motor vehicle convictions,
town and year (ex: drunk driving, no insurance, driving while suspended,
etc. if none, write none. If more than 3 offenses
Use back of this page.
Traffic
Violation Town Year
#1.__________________________________________________________
#2.
___________________________________________________________
#3.
___________________________________________________________
Prior Traffic ticket downgrades to no
point tickets since 1999 [39:4-97.2
unsafe driving]:
1. Town _______________________ Year
___________ [if none, write none]
2. Town _______________________ Year
___________
[Please note the DMV/MVC only permits 2 "no
point" downgrades. ]
What questions do you have? How can we
help you? What else is important? Please advise in criminal cases if you are
not a US citizen. Write
additional details on the back of this
page. _______________________________
Thank you for contacting Kenneth Vercammen
& Associates, PC for representation in a Municipal Court matter.
Legal Services To Be Provided- Please read and keep this page 3 for
yourself!
Write
your notes on the back of this paper during your interview
1. Office consultation with
client
2. Preparation
of statement to provide legal services [ retainer agreement ] setting forth
fees and work to be performed;
3. Offer sound legal advice to
client; 5 free calls with client during and after case
4. Preparation of Letter of Representation
to Municipal Court after fee paid;
5. Preparation of Letter of Representation
to Municipal Court Prosecutor;
6. Review documents supplied by
client and court;
7. Copies of all correspondence
to Court and Prosecutor to client;
8. Opening of
file and client may have free client case folder, Municipal Court brochure, MVC/DMV
points information brochure, and Expungement brochure;
9. Review of necessary statutes
and case law;
10. Follow up with Municipal
Prosecutor for discovery if suspension or jail is likely;
11. Prepare defense and
mitigating factors;
12. Miscellaneous
correspondence, drafting of brief/ pleadings if needed;
13. Review
Court hearing notice and send letter to client to remind them of hearing and what to bring to hearing
14. Travel to Municipal Court and
Representation in Municipal Court.
15. Preparation of End of Case
Letter with client questionnaire.
16. Free T-shirts, Can Coozies, Water bottle, Coffee Mug for
clients - Please ask.
17. Free subscription to monthly
e-mail newsletter providing legal updates
and recent criminal ,
traffic and insurance laws
19. Answer specific questions
after the case is over
18. Free Brochures provided on other legal topics
such as Personal Injury, Worker's Comp, Wills, Probate and other matter we help
clients
20. Invitations to annual client socials by email & Annual USA Flag
Calendar
We will review and research necessary statutes and
caselaw, speak with the prosecutor, prepare defenses and determine mitigating
factors. We agree to provide conscientious, competent and diligent services
and at all times will seek to achieve solutions, which are just and reasonable
for you.
Legal Fees. Fees are to be paid at initial consultation
(today).
Fees
must be paid by VISA, Master Card, American Express, check, money order or
cash.
Make checks payable to
Kenneth Vercammen Law Office today. Fees must be paid in full prior to a Letter
of Representation being sent to the Court. Neither this office nor other area
attorneys accept payment plans if the fees are less than $2,500. Fees are not
reduced and not negotiable. Under the NJ Rules of Professional Conduct and
Court Rules, we cannot send a letter of representation to the court until the
Retainer is paid in full
What
you should do: After you have
retained [paid] your attorney, call the court, and plead not guilty. In traffic
tickets, the phone number is on the back of the ticket. Judges will often ask you how many tickets you have had in the past 5
years. You want to be accurate with your response. In traffic matters we
recommend you contact the Motor Vehicle Commission and obtain a driver's
license abstract. Call 888-486-3339 or 609-292-6500. Please note the DMV/MVC
only permits 2 "no point" downgrades in 5 years. . If you have 2
downgrades to unsafe driving 39:4-97.2, you may not be eligible for a no point
ticket. If you do not wait 5 years, after the 2nd no point ticket,
the MVC computer will impose 4 points against you.
