Free Case Evaluation

Defending clients in the Olympia, Tacoma, and Pierce County areas

First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip:
Phone Number:
Okay to call you at this number?
Yes No
Alternate Phone:
Alternate number is a:
Okay to call you at this number?
 Yes No
Fax Number:
Okay to Fax?
Yes No
Email:
Okay to Email?
Yes No
How did you find this web site?
Please specify how you found us
(if not listed above):
If you have been charged with a crime, or are under investigation for a crime, what are the charges?
Date of Arrest:
Time of Arrest:
Day of the Week:
City Where Arrested:
County Where Arrested:
Court Date (leave blank if unsure):
Time of Court:
Name of Court:
Driver's License Number:
State Where Licensed:
Date of Birth:
If you have been charged with DUI/DWI, is this your first DUI/DWI in your ifetime--anywhere, anytime?
Yes No
Are you mainly interested in fighting your DUI, or do you want to plead nolo or guilty?
If you have had prior DUI's/DWI's please list them here:
  Month/Year -------- Court ------- Result (Guilty, Not Guilty, Nolo)
Are you currently on probation or parole?
Yes No
If "yes", where?
If "yes", for what offense(s)?
Other Tickets/Charges received with this DUI (check all that apply):

Failure to Maintain Lane
Speeding
Illegal U-Turn
Running Red Light/Stop Sign
Defective Equipment
No Proof of Insurance
Failure to Yield
Other
       (Please specify below...)

Please specify other charges( not listed above)
Why were you stopped/arrested, according to officer?
Was there an accident?
Yes No Not Sure
Was anyone injured? (check all that apply):
No one was hurt/Not applicable
Myself
Passenger(s) in my vehicle
Passenger(s) in another vehicle
Pedestrian
Not Sure
Were you stopped at a roadblock?
Yes No
Were you given field sobriety tests at the location where you were stopped?
Yes No Don't recall
I Refused
Which field sobriety tests were you given? (Check all that apply)
Hand held Breath Test
Walking heel to toe
One-Leg Stand
Follow-the-Pen-With-Eyes
Say the Alphabet
Touch Your Nose
Other (Please specify below...)
Please specify other tests you took, that are not listed above:
Did officer advise you that field tests were 100% optional and that no penalty would result from not doing them?
Yes No
Were you videotaped at any point during your arrest?
Yes No Not Sure
Did you take breath test?
Yes
No, I Refused
No, Test Was Not Offered to Me
No, I Was Given a Blood Test
I was given all three test -- blood, breath and urine
Not Sure

WARNING : If arrested for DUI / DWI, you have 30 days from the date of your arrest to request a hearing with the Washington Department of Licensing. Failure to request a hearing within the allotted time will result in the immediate suspension of your license, up to 2 years if you refused a Breath Test.

CALL OUR OFFICE IMMEDIATELY FOR ASSISTANCE!
If you took a breath test you should POSSESS a print-out of the two test samples. List your breath test results here:
Sample #1
Sample #2
Blood test results (if known):
Check here if test results are pending
Name of testing officer?
Name of arresting officer?
Name of police department?
Street or location v_bond_post where stopped?
County where stopped?
Was your car towed?
Yes No
Who authorized the tow truck?
I Did Officer Did Not Sure
Who posted bond?
I Did Bonding Company
Family Member/Friend Other
Amount of bond?
Were there any witnesses with you who could testify for you?
Yes No
At any time during your arrest did you ever ask for or inquire about getting your own independent blood, breath or urine test?
Yes No
Did you get an independent blood, breath or urine test?
Yes No
If "yes", what was the result?
Check here if test results are pending
Did you ever ask to call an attorney?
Yes No
If "yes", when (give details)?
Additional Comments Are Welcome:
 
Tacoma, WA DWI Attorney

The Lane Law Firm
1800 Cooper Point Road SW, #3
Olympia, WA 98502

866.438.3999 (toll free 24/7)
360.352.8887 (M-F 8:00-5:00)
360.956.3391 (fax)