Your Name (required)
Client Name (required)
County of Case (required) AllenAdamsDeKalbLaGrangeNobleHuntingtonSteubenWellsWhitley
Type of Case (required)
Date Case Opened (required)
Date Case Closed (required)
Case Outcome (required) Court DecisionCounsel/AdviceNegotiated SettlementWith LitigationWithout LitigationClient WithdrewAttorney WithdrewAgency DecisionOther
Attorney Hours (required)
Legal Assistant Hours (required)
Business Phone (required)
Attorney Email (required)
Additional Notes (required)
Request Hours
