MARGARET GETTLE WASHBURN, P.C.
ATTORNEY AT LAW
4799 Sugarloaf Parkway
Building J
Lawrenceville, GA 30044
770-963-1105
770-963-2828 facsimile
NEW CLIENT INFORMATION SHEET
Welcome to our office!
Please complete this form. The information provided is strictly confidential and is to be
used only in connection with legal services that may be performed for you. Date:___________
NAME: _________________________________________________________________
DATE OF BIRTH:_____________________________________________________________
SOCIAL SECURITY NO.:______________________________________________________
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MAILING ADDRESS: _______________________________________________________
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HOME PHONE:______________________________________________________________
PAGER:___________________________________ CELLULAR:______________________
EMAIL:___________________________________ EMAIL #2:________________________
EMPLOYER NAME AND ADDRESS:___________________________________________
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(______) Please check here if you need notification before receiving facsimile transmittals.
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always be able to reach you:_____________________________________________________
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STATE BRIEFLY THE NATURE OF YOUR CASE:________________________________
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