Justin King - Initial Client Interview
Initial Client Interview Form
A. CLIENT PERSONAL INFORMATION
Name: Justin King
Address: 123 Main Street, Kansas City, Missouri
Home Phone: (913)123-4567 Work Phone: (913)890-1234
Social Security Number: 123-45-6789
Driver’s License Number: MO39562243
Date of Birth: 7/14/83
Marital Status: Single Dependents: None
Military Status: N/A
Occupation: Student/Retail
Employer Name, Address, Phone Number:
__________________________________________________________
Membership in Union or Professional Organization: N/A
Police Record (if any): N/A
Have you ever filed bankruptcy? If so, please explain. N/A
B. CLIENT EMPLOYMENT
Type of Work: Retail Sales Job Title: Cashier
Immediate Supervisor’s Name: Jill Janes
Salary or Hourly Rate: $7.75/hour
Number of Hours Worked Weekly - Before Accident 20 - After Accident 0
Benefits (Company car, pension plan, vacation, expense account, etc.)
N/A
D. CLIENT’S FACTS/STORY: BE AS DETAILED AS YOU CAN BE. INCLUDE DAMAGES AND ALL NAMES TOLD BY CLIENT
Client, Justin King, claims he was a potential rising star (a singer) who had won the “National Idol Regional Contest” last year, on April 5th, in Chicago and that he was awarded a three year recording contract for $275,000 a yr plus a percentage of all sales with MCI Records. Mr. King further states that due to an accident on Interstate 57, just south of Chicago, he is now unable to fulfill his contractual duties because of injuries sustained to his jaw and face. Mr. King goes on to state that on or around the 8th of April he had left his agents house after signing his contract. He states that he was driving his motorcycle and was on his way home and he was “pretty freaking happy.” He said that he was driving in the left hand lane, going southbound on Interstate 57 when he noticed a beer truck going in the same direction (he’s unsure of the name-it’s either Coops, Coops Light or Coops Ultra), coming
A. CLIENT PERSONAL INFORMATION
Name: Justin King
Address: 123 Main Street, Kansas City, Missouri
Home Phone: (913)123-4567 Work Phone: (913)890-1234
Social Security Number: 123-45-6789
Driver’s License Number: MO39562243
Date of Birth: 7/14/83
Marital Status: Single Dependents: None
Military Status: N/A
Occupation: Student/Retail
Employer Name, Address, Phone Number:
__________________________________________________________
Membership in Union or Professional Organization: N/A
Police Record (if any): N/A
Have you ever filed bankruptcy? If so, please explain. N/A
B. CLIENT EMPLOYMENT
Type of Work: Retail Sales Job Title: Cashier
Immediate Supervisor’s Name: Jill Janes
Salary or Hourly Rate: $7.75/hour
Number of Hours Worked Weekly - Before Accident 20 - After Accident 0
Benefits (Company car, pension plan, vacation, expense account, etc.)
N/A
D. CLIENT’S FACTS/STORY: BE AS DETAILED AS YOU CAN BE. INCLUDE DAMAGES AND ALL NAMES TOLD BY CLIENT
Client, Justin King, claims he was a potential rising star (a singer) who had won the “National Idol Regional Contest” last year, on April 5th, in Chicago and that he was awarded a three year recording contract for $275,000 a yr plus a percentage of all sales with MCI Records. Mr. King further states that due to an accident on Interstate 57, just south of Chicago, he is now unable to fulfill his contractual duties because of injuries sustained to his jaw and face. Mr. King goes on to state that on or around the 8th of April he had left his agents house after signing his contract. He states that he was driving his motorcycle and was on his way home and he was “pretty freaking happy.” He said that he was driving in the left hand lane, going southbound on Interstate 57 when he noticed a beer truck going in the same direction (he’s unsure of the name-it’s either Coops, Coops Light or Coops Ultra), coming