— ELIGIBILITY REVIEW FORM —

I WISH FOR THE HOWSON LAW OFFICE TO CONTACT ME ABOUT SCHEDULING AN APPOINTMENT IF IT APPEARS FROM THE INFORMATION PROVIDED HEREIN THAT I MAY BE ELIGIBLE FOR RELIEF.

I UNDERSTAND THAT I AM UNDER NO OBLIGATION TO SCHEDULE AN APPOINTMENT OR TO EMPLOY THE HOWSON LAW FIRM TO PROVIDE ANY SERVICE FOLLOWING AN APPOINTMENT. I FURTHER UNDERSTAND THAT THE INFORMATION PROVIDED HEREIN SHALL REMAIN CONFIDENTIAL.

TYPE OF RELIEF SOUGHT:

vacate conviction
restore firearm rights
both

FULL NAME:
(as it appears on the conviction in question)

CONTACT PHONE NUMBER:

DATE OF BIRTH:

TYPE OF CONVICTION:

felony
misdemeanor
not known

IF FOR A FELONY, HAVE YOU RECEIVED A "CERTIFICATE OF DISCHARGE?"

YES
NO
UNSURE

IF YES, WHAT DATE WAS IT SIGNED?

OFFENSE(S) CONVICTED OF:
(Name of crime, e.g. "burglary," "theft," "disorderly conduct," etc.)

DID THE OFFENSE(S) INVOLVE "DOMESTIC VIOLENCE?" (i.e. WAS NOTED AS "DV.")

YES
NO

COURT WHERE CONVICTION OCCURRED:
("Superior Court," "District Court," or one of the Municipal courts, e.g. "Sedro-Woolley," or "Burlington," etc.)

DATE OF CONVICTION:
(As close as you can provide-at least the approximate year)

CASE NUMBER OF CONVICTION:
(If known—this number appears in the upper right-hand portion of any court document)

A BRIEF STATEMENT OF WHAT BROUGHT THE NEED FOR THIS PROCEDURE TO YOUR ATTENTION: (denied employment, denied purchase of a firearm, etc.)

SUBMIT FORM