If your commercial vehicle was towed under questionable circumstances, we want to hear from you. This form helps us understand your situation and determine if we can assist you. All information is confidential and protected by attorney-client privilege once you retain our firm.
Full Name:
[____________]
Phone Number:
[____________]
Email Address:
[____________]
County/State Where Towing Occurred:
[____________]
Name of Towing Company (if known):
[____________]
Location Where Vehicle Was Towed From:
(truck stop name, gas station name, address, or description)
[________]
[__________]
Date Vehicle Was Towed:
[____________]
Type of Vehicle:
(e.g., semi-truck, trailer, box truck, flatbed, etc.)
[____________]
Estimated Vehicle Value:
$[____________]
Was Your Vehicle Returned?
Did You Pay Any Fees?
If yes, please provide details:
Amount paid: $[____________]
How did you pay? (check all that apply)
– [ ] Cash
– [ ] Credit/debit card
– [ ] Check
– [ ] Wire transfer
– [ ] Other: [______]
Were You Threatened or Intimidated?
If yes, please describe:
[________]
[_______]
[_________]
Brief Description of What Happened:
Please provide as much detail as you can remember about:
– What were you doing when you discovered the vehicle was towed?
– What did the tow company representative(s) tell you about why the vehicle was towed?
– What signage, if any, was posted at the location?
– What communications did you have with the tow company?
– Did the tow company provide written documentation of the tow?
– Were any threats made toward you or anyone else?
– Was the vehicle transported to a different location or state?
– Has the title been transferred, or have you been asked to sign over the title?
[________]
[_______]
[______]
[______]
[_________]
Do you have any of the following? (Check what applies)
I understand that submitting this form does not create an attorney-client relationship. This form is submitted for the purpose of initial consultation only. Any information I provide will be reviewed, and if Weldy Law Firm, PLLC determines that we can assist you, we will contact you to discuss representation and fee arrangements.
I understand that all information is confidential and protected under attorney-client privilege once I formally engage the firm for legal representation.
I have read and understood the above:
[ ] Yes, I agree
Please send this completed form to:
Weldy Law Firm, PLLC
1530 North State Street
Jackson, Mississippi 39202
Phone: (601) 624-7460
Email: Chris@WeldyLawFirm.com
You can submit this form by:
1. Email (attach as PDF or Word document)
2. Mail (printed and signed)
3. Phone (call to discuss your situation)
This website is published by Weldy Law Firm, PLLC. The information presented is educational in nature and is not a substitute for professional legal advice. Past results do not guarantee future outcomes.
By submitting this intake form, you are not creating an attorney-client relationship. Only after you sign a representation agreement with Weldy Law Firm, PLLC and the firm agrees to represent you will an attorney-client relationship exist.
All information submitted in this form is confidential. However, do not include sensitive financial information such as bank account numbers, social security numbers, or credit card numbers. If you have questions about what information to include, please call us first at (601) 624-7460.
Weldy Law Firm, PLLC
Christopher Weldy, Attorney
1530 North State Street
Jackson, Mississippi 39202
(601) 624-7460
Chris@WeldyLawFirm.com
Weldy Law Firm, PLLC is licensed to practice law in the State of Mississippi.
