Traffic Ticket Case Evaluation - Fort Worth Attorney Womack
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Traffic Citation Questionnaire
Thank you for your interest in the services of Clifford M. Womack. So that we may better understand and evaluate your legal needs, please fill out the following quick survey. We will contact you regarding you claim shortly.
Name
*
First
Last
Email
*
Phone
*
Date of Incident:
MM
DD
YYYY
Check your Citation for this information.
Time of Incident:
:
HH
MM
AM
PM
Check your Citation for this information.
City:
County:
State:
Location:
Issuing Police Dept.
Fine:
Please do not use $ sign
Citation Violations:
List all violations.
Did you recieve a DWI/DUI?
Yes
No
Did this involve an accident or injury caused to another person?
Yes
No
Please briefly describe the accident and/or injuries caused:
How did you find out about us? (optional)
Captcha
Enter the math answer.
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Law Office of Clifford M. Womack
1751 River Run, Suite #211
Fort Worth, Texas 76107
info@attorneywomack.com
817-546-3888
CALL TODAY
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