Truck Lawyer Alexander & Angelas P.C. - Attorneys and Counselors

Alexander & Angelas, P.C. New Case Intake form
Date:
Name of Case:
Name of Insurance Company:
Adjusters Name:
Adjusters Telephone:
Adjusters Email:
Date Served:
Service Personal, Mail or other:
Has Extension been secured?	Yes No
If yes, until when?
Has Extension been confirmed in writing?	Yes No
Court and Case Number:
Plaintiff Attorney Information:
Appearing For:
Have file materials been sent by insurance carrier?	Yes No
If yes, when:
If no, when:
Claim Number:
Date of Loss:
Location of Loss:
Description of Loss:
Assistance Requested:
SUBMISSION OF THIS FORM DOES NOT CONSTITUTE THE CREATION OF AN ATTORNEY-CLIENT RELATIONSHIP. AN ATTORNEY-CLIENT RELATIONSHIP SHALL ONLY BE CREATED AFTER ALEXANDER & ANGELAS, P.C. EXPRESSLY ACKNOWLEDGES A CASE REFERRAL AND/OR RETENTION FOR LEGAL SERVICES.

Federal Motor Carrier Safety Administration
Safety programs, regulations, and facts related to the prevention of commercial motor vehicle-related injuries and fatalities.

Insurance Information Institute
Includes information on vehicle safety, insurance, and more.

Insurance Institute for Highway Safety / Highway Loss Data Institute
Features vehicle ratings, safety facts, publications and more

National Highway Traffic Safety Administration
Provides crash statistics and articles about traffic accidents and vehicle safety.

Share The Road Safely - The No Zone
From the Federal Motor Carrier Safety Administration, dedicated to reducing motor vehicle accidents involving large trucks.

U.S. Department of Transportation
Features statistics, dockets, rules and references.

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