Cal West Law
21800 Oxnard Street Suite 720,
Woodland Hills, CA 91367
(818) 788-5008
The Intake form aims to assist us in comprehending your case.
Please complete this form entirely.
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In the past eight years, have you gone by any other names?
Yes
list other names used. (Include married, maiden, and trade names)
No
In the past 8 years, have you used any business names or Employer Identification Numbers (EIN)?
Yes
Business Name?
What is the Business address?
Employer Identification Numbers (EIN) used ?
Nature of the business?
When was the business opened?
if closed, when did it close ?
Are there any outstanding accounts receivable owed to the business?
Does the business own any furniture, equipment, or other items? If so, could you provide details on the type of items and their estimated value if sold at a garage sale?
Do you or your business receive royalties or residuals?
Did the business receive royalties or residuals this year? If so, what was the amount received?
Will you receive any residuals in the future? If so, what would be the estimated amount?
No
Have you lived at the address given for at least 180 days?
Yes
No
What was your previous address? (Need complete Address including City ,State & Zip code)
When did you move in?
When did you move out?
Have you lived at the address given for at least 730 days (2 years)?
Yes
No
What was your previous address?(Need complete Address including City ,State & Zip code)
When did you move in?
When did you move out?
Please provide an alternative mailing address if it is different from the address given.
Gender
Male
Female
Other
What is your social security number ?
Date of birth?
What is your communication preference ?
Select an option
Email
Phone call
Text
Marital Status
Single
Married
When did you get married?
Spouse's Full Name?
Date of birth?
Is your spouse employed? If yes please let us know the employer’s Name, Job title & length of employment.
Business Name?
Employer Identification Numbers (EIN) used?
Nature of the business?
When was the business opened?
if closed, when did it close?
Are there any outstanding accounts receivable owed to the business?
Does the Business own any furniture, equipment, or other items? If so, could you provide details on the type of items and their estimated value if sold at a garage sale?
If the business receives royalties or residuals , what amount was received this year?
Do you or your business receive any royalties or residuals?
Did the business receive any royalties or residuals this year? If so, what was the amount received?
Will you receive any residuals in the future? If so, what would be the estimated amount?
Are you and your spouse filing together?
Yes
In the last 8 years, has your partner used any alternate names? If so, provide a list of such names.
In the past 8 years, has your partner used any business names or Employer Identification Numbers (EIN)? If so, provide a list of the business names and/or EINs that were used.
What is your spouse's Social Security Number?
What’s their Telephone Number & Email address?
Has your partner resided at the address provided for a minimum of 180 days? which is equivalent to 6 months. (If not need complete Address including City ,State & Zip code)
Has your partner resided at the address provided for a minimum of 730 days, which is equivalent to 2 years?(If not need complete Address including City ,State & Zip code)
No
Are you married but separated?
Yes
When did you separate?
Have you filed for divorce?
No
Do you have children ?
Yes
How many of Children live at home ?
Full name?
Gender ?
Age ?
No
Where does your income come from?
WAGES
What's your Employers Company Name?
Address?
What is your Job Title?
How long have you worked for this company?
SOCIAL SECURITY BENEFITS
How much do you receive monthly?
How often do you receive benefits?
SELF EMPLOYED
How much do you estimate you make monthly?
PENSION
How much do you receive monthly?
How much do you receive monthly?
COMMISSION
How much do you receive monthly?
How often do you receive this income?
ROYALTIES
How much do you receive monthly?
How often do you receive this income?
DIVIDENDS
How much do you receive monthly?
How often do you receive this income?
RENTALS
How much do you receive monthly?
How often do you receive this income?
OTHER
UNEMPLOYMENT
How much do you receive monthly?
How often do you receive this income?
Have you sold property in the last 4 years?
Yes
Property description
How much did your recieve?
When did you sell it ?
No
Do you currently have any life insurance policies?
Yes
What type of policy? (Whole life or Universal)
What is the cash value?
No
Do you own any cryptocurrency stocks? (Examples: Coinbase, Voyager Kraken, Bitcoin IRA, Etc.)
Yes
We require statements for each account that show the balance in the account(s). If the statement(s) we receive do not meet the specified requirements, we may request additional information.
No
Are you involved in stock trading?(Examples: Robinhood, E*Trade, TD Ameritrade, Etc.)
Yes
We require statements for each account that show the balance in the account(s). If the statement(s) we receive do not meet the specified requirements, we may request additional information.
No
Do you owe income taxes?
Yes
Federal ? Which Year(s)? Amount(s)? ( ex. Federal - 2018 - $5,000.00 )
State ? Which Year(s)? Amount(s)? ( ex. State - 2018 - $5,000.00 )
No
Do you own real estate? This includes homes, buildings, or anything permanently attached to land.
Yes
What is your 1st mortgage payoff amount ?
Monthly Payment ?
Does your monthly payment include taxes and insurance?
What is the monthly payment for HOA?
Are you behind on any payments? If yes, Mortgage or HOA? How many?
When did you purchase the property?
Is there a balloon payment involved?
Do you have a 2nd mortgage?
Monthly Payment?
What is your 2nd mortgage payoff amount?
Does your monthly payment include taxes and insurance?
When was the debt incurred?
Is there a balloon payment involved?
Are there any other liens?
No
Are you currently renting a residential property?
Yes
What is your monthly payment?
Are you behind on payments?
If the answer is yes, could you please specify the number of months?
Are you currently facing an eviction? If so, provide the landlords name and address.
No
Do you an have interest in any vehicle?
Yes
What year was it made ?
What is the Make?
Model?
Mileage?
Is this vehicle Purchased/ leased?
What is the amount of your monthly payment?
What is the Payoff Amount?
What is the conservative market value?
Do you plan on keeping the vehicle?
No
Do you an have interest in a 2nd vehicle?
Yes
What year was it made ?
What is the Make?
Model?
Mileage?
Is this vehicle Purchased/ leased?
What is the amount of your monthly payment?
What is the Payoff Amount?
What is the conservative market value?
Do you plan on keeping the vehicle?
No
Do you an have interest in a 3rd vehicle?
Yes
What year was it made ?
What is the Make?
Model?
Mileage?
Is this vehicle Purchased/ leased?
What is the amount of your monthly payment?
What is the Payoff Amount?
What is the conservative market value?
Do you plan on keeping the vehicle?
No
Do you an have interest in a 4th vehicle?
Yes
What year was it made ?
What is the Make?
Model?
Mileage?
Is this vehicle Purchased/ leased?
What is the amount of your monthly payment?
What is the Payoff Amount?
What is the conservative market value?
Do you plan on keeping the vehicle?
No
Have you taken any cash advances or balance transfers on your credit cards within the last 90 days?
Yes
When was the advance taken?
How much was taken?
Company name?
No
Have you ever signed on as a co-signer for someone else's debt?
Yes
What is the person's Name?
What is their relationship to you?
What was it for?
How much was it for?
Date debt was incurred?
No
Have you ever filed bankruptcy?
Yes
What city and state was the bankruptcy filed in?
Filing date?
Case number?
Was it discharged?
What bankruptcy chapter did you file?
No
Do you currently have any current wage garnishments or bank levies affecting your income?
Yes
Creditor Name?
No
Are you currently facing foreclosure?
Yes
Have you been given a sale date? If yes, what is the date?
What is the TS No.?
No
Are you currently facing a lawsuit?
Yes
Provide a copy of the lawsuit.
No
Are you responsible for any spousal support obligations?
Yes
Name of the claim holder?
Address?
Is the support court ordered?
No
Are you responsible for any child support obligations?
Yes
Child Name?
Age?
Monthly payment?
Is the support court ordered?
No
What is your estimated amount of liabilities?
How were you referred to our law firm?
Friend or family member
Full name?
Another attorney
Attorney's full name?
Online search or lawyer directory website
Website?
For example, "Avvo", "Facebook", or "LawFirmName.com"
Billboard, bus stop, phone book, newspaper, or other physical advertisement
Where was the ad located?
Radio or TV advertisement
What radio or TV station?
Bar association
Which Bar Association?
Other
Please explain how you found us:
If our law firm ends up representing you in this matter, will you be the person who pays the legal fees?
Yes
How do you plan to pay?
Please indicate the source of funds or otherwise confirm that you have the ability to pay your legal fees.
No
Full name of the person who will pay the legal fees?
phone number?
Email address?
ACKNOWLEDGEMENT AND ACCEPTANCE
I hereby acknowledge that I have carefully reviewed and consented to the privacy policy, which specifies the intended use of my personal information.
PRIVACY POLICY
Our firm values your privacy and ensures that all information provided by our clients is kept confidential. To safeguard your data, we use industry-standard 128-bit SSL encryption to secure the information submitted through this form. Your Social Security number and personal details will only be accessed if you hire us to represent you in your legal matter. Even then, we will only use this information when it is necessary and limited to your case. Social Security numbers are typically required by courts to positively identify parties involved in a case. We may also use this information for initial service, in court orders, and in reports or documents filed. If you have any questions regarding our privacy policy, please don't hesitate to contact us.