Civil Litigation

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: N/A

__________________________________________________________

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

According to the client a couple days before the accident he won a regional singing contest called National Idol on or around April 5th that was held in Chicago. Mr. King states that he was offered a three year recording contract for $275,000a year plus he gets a percentage of the sales from MCI Records out of Nashville, TN but they did the deal in Chicago the day after he won the contest. Around about on the 8th of April Mr. King was traveling sound bound on Interstate 57 just south of Chicago where he was coming back from his agent’s house after signing the contract for MCI. He was on his motorcycle in the left land going about 60-65 mph when a large beer truck come up beside him so Mr. King got over in the right lane so the tuck could pass. Mr. King thinks the truck had the logo for Coops Beer on the side. Mr. King states that he notices cases of beer are falling out of the truck and coming right at him he swerved to the left to get out...