Civil Litigation Unit 1 Kaplan

Initial Client Interview Form

A. CLIENT PERSONAL INFORMATION

Name: Justin King

Address: 123 Main Street, Chicago, Illinois 60601

Home Phone: (913)123-4567 Work Phone: (913)890-1234

Social Security Number: 123-45-6789

Driver’s License Number: IL39562243

Date of Birth: 7/14/83

Marital Status: Single Dependents: None

Military Status: N/A

Occupation: Student/Retail

Employer Name, Address, Phone Number:

__________________________________________________________

Membership in Union or Professional Organization: N/A

Police Record (if any): N/A

Have you ever filed bankruptcy? If so, please explain. N/A

B. CLIENT EMPLOYMENT

Type of Work: Retail Sales Job Title: Cashier

Immediate Supervisor’s Name: Jill Janes

Salary or Hourly Rate: $7.75/hour

Number of Hours Worked Weekly - Before Accident 20

- After Accident 0

Benefits (Company car, pension plan, vacation, expense account, etc.)

N/A

D. CLIENT’S FACTS/STORY: BE AS DETAILED AS YOU CAN BE. INCLUDE DAMAGES AND ALL NAMES TOLD BY CLIENT

Justin King was a contestant on National Idol, he was subsequently offered a 3 year contract by MCI records. After signing the contract in Chicago Mr. King was driving southbound on I-57 towards KCMO. Mr. King was in the left lane going approximately 60-65 mph, he states he saw a beer truck; specifically Coops beer, when he saw flashing lights from the truck when all of a sudden cases of beer came flying out of the truck causing Mr. King to swerve left to attempt to avoid getting hit by an object. Mr. King remembers nothing after until waking up in Paxton ICU with his jaw wired shut. Doctors advised that Justin had 9 broken bones in his face. At some point Mr. King was informed by his agent that because of his injury he would not be able to compete and that MCI was going to cancel his contract. After hearing this Justin attempted to loosen his wires to try and sing, doing so the staff caught...