155 N. Riverview Drive
Suite 100
Anaheim, CA 92808
Phone: 714.529.5685

                                                             CASE SUBMISSION FORM

                                                    PLEASE COMPLETE THIS FORM TO BEGIN RESOLVING YOUR DISPUTE.


Party Name (Required)
Attorney Name (Required)
Address (R)
Phone (Required)
Fax (Required)
E-Mail Address (Required)
Name of adverse party (Required)
Name of adverse Attorney (Required)
Address (R)
Phone (Required)
Fax (Required)
E-Mail Address (Required)
Case Name (Required)
Court case number
Briefly describe the nature and type of dispute (R)
Please identify all court dates
What is the status of discovery? (R)
What hearing dates are you requesting? (Required)
What is your estimate of the hearing length? (Required)
If more than two parties, please provide additional parties contact information and if represented their attorney's information
If insurance companies are involved, please provide the name and phone number of each company, its adjuster and identify the party affilation
Are there any things you and the other party might agree upon? (R)
What is the approximate monetary value of the items under dispute?
What non-monetary relief do the parties seek?

Note: Please do not include any URLs in form.

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