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Criminal Arrest Evaluation
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Offices by Appointment

8370 Veterans Highway
Suite 201
Millersville, MD 21108

Mailing Address

Post Office Box 694
Columbia, MD 21045

Telephone

443-324-5289

Facsimile

410-729-4186

Criminal Defense

Criminal Arrest Evaluation

If you have been arrested for a crime, complete this free survey, or call 443-324-5289 for a initial consultation with Scott Athen.

If you have been arrested for DUI/DWI, please complete the DUI Arrest Evaluation.  If you have received a Maryland traffic citation, but have not been arrested for DUI/DWI, please complete the Traffic Citation Evaluation.

Completion of this survey does not create an Attorney-Client Relationship between the person completing the form and The Law Offices of Scott C. Athen or Scott C. Athen, Esq.  However, the information provided by completing this form is protected under Attorney-Client privilege, and will not be released to anyone other than Scott Athen.  Upon receiving and reading your answers, Mr. Athen will contact you by the means chosen at the beginning of the survey to arrange your free initial consultation at one of his offices, or in your home.

Fields marked '*' are required.

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Full Name*
Street Address*
City*
State*	Alabama Alaska Arizona Arkansas California Colorado Connecticut Deleware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massacheusetts Michigan Minnesota Mississippi Missouri Montana Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
E-mail address*
OK to e-mail you at this address?	Yes No
Phone No.*	Home Work Cell Other
OK to call you at this number?	Yes No
Alternate Phone No.	Home Work Cell Other
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Date of Birth*
Height*	Height 4' 0" 4' 1" 4' 2" 4' 3" 4' 5" 4' 6" 4' 7" 4' 8" 4' 9" 4' 10" 4' 11" 5' 0" 5' 1" 5' 2" 5' 3" 5' 4" 5' 5" 5' 6" 5' 7" 5' 8" 5' 9" 5' 10" 5' 11" 6' 0" 6' 1" 6' 2" 6' 3" 6' 4" 6' 5" 6' 6" 6' 7" 6' 8" 6' 9" 6' 10" 6' 11" 7' 0" 7' 1" 7' 2" 7' 3" 7' 4" 7' 5" 7' 6" 7' 7" 7' 8" 7' 9" 7' 10" 7' 11"
Weight*	Pounds
Education	Choose One No High School Some High School High School Grad Some College College Degree (2-Year) College Degree (4-Year) Some Graduate Graduate Degree Some Doctorate Doctorate
Employment*	Choose One Accomidation Accounting Agriculture Amusement & Recreation Banks & Financial Institutions Communications Computers Construction Consulting Education Electronics Financial Brokers & Exchanges Fishing Food & Beverage Government - Federal Government - State Governmebt - Local Health & Social Services Homemaker Insurance Legal Manufacturing Mining Oil & Gas Personal/Individual Real Estate Retail Secretarial Security Services Storage & Warehousing Student Telecommunications Utilities Other
Length of employment*	Mo/Yr Months Years
Social Security Number*
Drivers license No.*
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Date of arrest*
Time of stop/arrest
County arrested in*	Choose One Allegany County Anne Arundel County Baltimore City Baltimore County Calvert County Caroline County Carroll County Cecil County Charles County Dorchester County Frederick County Garrett County Harford County Howard County Kent County Montgomery County Prince George's County Queen Anne's County St. Mary's County Somerset County Talbot County Washington County Wicomico County Worcester County
Street or location of arrest*
Name of police department
Officer's name & badge number
Why were you stopped/arrested, according to the Officer?*
Please list all Citation/Charging Numbers*
Please list all charges*	(Statute#---Name of Charge)
Was there a Search Warrant?	Yes No Don't Know/Not Sure
Were you Mirandized? (You have the right to remain silent, anything you say can and will be used against you in a court of law...)	Yes No Don't Know/Not Sure
Did you make any statements to the police? If 'yes', please explain	Yes No
Did you ever ask to speak with a lawyer? If 'yes', when? (please give details)	Yes No
Additional comments

Please click 'Send Criminal Arrest Evaluation to Scott Athen' only once.