Interview Form

Name *
County of Residence *
County in which crime allegedly occurred *
Phone Number
E-mail address
Crime(s) of which you are accused
Are you a United States citizen?	Yes No
In your own words, what happened?
Did anything unusual happen during your arrest? If so, what?
Did police search, you, your automobile, or your residence?	Yes No
Were any other people present with you?	Yes No
If so, were they charged with the same crime(s)?	Yes No
Did police take anything? If so, what?
Did you make a written or oral statement to the police or answer any questions they asked you? If so, what did you tell them?
Do you have any outstanding warrants for your arrest?	Yes No
Do you have any other criminal cases pending?	Yes No
Are you on probation or parole?	Yes No

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