The Law Office of Hoot Crawford, P.A.
A Law Firm Proudly Providing Legal Services to Citizens in Panama City, Bay County, Florida and the surrounding Counties in the legal areas of Criminal Defense, Family Law, Civil Litigation, and DUI.

  
Home Firm Overview Practice Areas Associate Profiles
DUI FAQs Criminal Law FAQs Resource Links Request Evaluation Contact
 
*First Name: *Last Name:
Address
(Number, Street, City, State, Zip):		 *Phone:  
Ok to call you at this phone?
Alternate Phone:
Ok to call you at this phone?
*Email Address: How did you hear about us?

How do you want to handle your
D.U.I? (fight, no contest, guilty?)

 Date of incident:    
City where incident occurred: County where incident
occurred:
Are you currently on probation: If on probation, where?
If on probation, for what type of
charge?		 Court date (leave blank if
unsure):
Time on date to be at court: Name of court:
Driver's License Number: State where licensed:
Date of Birth (mm/dd/yy): Is this the first DUI/DWI
you've ever gotten?  In your
whole life?
Were other tickets or charges
received with your DUI/DWI?
If so what are they? (leave blank
if this does not apply)		 If it is not your first DUI/DWI,
list prior incidents here (List
Month/Year, Court Name and
Result please):
Was there an accident?: Was anyone hurt in this
accident?  List all people
hurt in this incident and
their role (ex., passenger in
my car,  passenger in car
hit by my vehicle, etc)
Were you stopped at a DUI/DWI
checkpoint?		 Were you given field sobriety
tests? If so, what type?
Please list what you did in
each test.
Did the officer explain to you that
field sobriety tests are 100%
optional and that no penalty
would result from not doing them?		 Were you video-taped at all
during your arrest?
Did you take a blood, breath or
urine test? List any or all of
these you took.		 List all other relevant
information here:

WARNING:
IF YOU WERE ARRESTED FOR DUI YOUR LICENSE WILL BE SUSPENDED AND YOU HAVE ONLY TEN DAYS TO REQUEST A HEARING WHETHER YOU SUBMITTED TO THE TEST OR REFUSED THE TEST. THE SUSPENSION MAY BE FROM 6 TO 18 MONTHS AND IS AUTOMATIC UNLESS YOU REQUEST A HEARING WITHIN TEN DAYS FROM THE DATE OF THE TICKET. IF YOU CONTACT MY OFFICE BEFORE THE TEN DAYS HAS ELAPSED MY WELL TRAINED STAFF WILL ASSIST YOU IN REQUESTING THE HEARING AND HELP PROTECT YOUR RIGHT TO DRIVE AT NO OBLIGATION TO YOU. YOU WILL NEED TO FAX A COPY OF YOUR TICKET TO 850-872-8228 AND CALL MY OFFICE AT 850-913-9661 TO PROVIDE OTHER DETAILS NOT INCLUDED ON THIS FORM. DO NOT DELAY IN REQUESTING A HEARING OR CALLING MY OFFICE FOR ASSISTANCE IN REQUESTING A HEARING. CALL OUR OFFICE IMMEDIATELY FOR ASSISTANCE!