New Client Information Sheet | Mark Jepson Law | Hamilton, Waikato, NZ

* Full legal name

Please provide a valid entry.

* Physical Address

Please provide a valid entry.

Postal Address (If different from above)

* Email address

Please provide a valid entry.

* Mobile phone number

Please provide a valid entry.

Secondary phone number

Personal Information

* Date of Birth

Please provide a valid entry.

Drivers' Licence Number

* Employment Status

Please provide a valid entry.

* Employer or Company Name

Please provide a valid entry.

* Occupation

Please provide a valid entry.

Instructions

* Instructions

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Next Court Date, Time and Place

Proof of Identification and Address

Once you receive a confirmation email from this form please reply with proof of identification and proof of address. Satisfactory identification includes photo drivers' licence, passport, firearms licence or 18+ card. Satisfactory proof of physical address includes any utility bill or rates demand addressed to you and sent to your home address.

Agreement to Terms of Instructions and Engagement

I agree to instruct Mark Jepson Law as outlined in the Terms of Instructions (a copy can be requested at any time) as set out in the following link

You must agree before submitting.

I have read and understand the Terms of Engagement (a copy can be requested at any time) as set out in the following link

You must agree before submitting.

If you are having issues with this form please call Mark on 021 633 460 or email at mark@jepson.co.nz or visit the Home page for further contact information.

Mark Jepson Law

Criminal, civil and traffic law, Hamilton, NZ.

Phone or text 021 633 460

New Client Information Form

Contact Information

Personal Information

Instructions

Proof of Identification and Address

Agreement to Terms of Instructions and Engagement