Contact Us

Gallot Law Office
Personal Injury Attorney
203 South Vienna Street
Ruston, LA 71270
Phone: (318) 251-8480
Fax: (318) 251-8481

Criminal Law Form

*Name:
*Address:
*City:
*State:
*Zip:
*E-mail address:
*Home Phone:
Business Phone:
Cellular or Pager:
Facsimile:
Booking #:
Court Date:
Time:
Court Name:
Division/Room:
Arresting Officer's Name and Badge:
City of Arrest:
What were you arrested for (include Code section if known)?
Was the crime for which you were arrested a
Have you been convicted of a similar crime before?
YesNo
If yes, when?
Have you been convicted of other offenses?
YesNo
If yes, what and when?
Are you on probation or parole?
YesNo
For what?
Do you have any other cases pending?
YesNo
Was anyone else arrested?
YesNo
If so, name(s) of all persons arrested:
What statements do you remember making to the police about the alleged crime?
Describe the order of events leading up to the arrest:
Have you discussed the alleged crime with anybody else?
YesNo
If so, who did you discuss it with and what did you tell them?
Were there any witnesses to the alleged crime?
YesNo
If yes, provide names and contact information if known:
What is the amount of the bond you posted?
Are there any special bond conditions?
YesNo
Were you referred by somebody else?
YesNo
Who?
Special Concerns:
Where did you hear about this website?
 

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