Charles M. Rowland Esq. | Springfield Ohio Fairborn Ohio Dayton Ohio

Dayton DUI Attorneys

Contact Our Dayton DUI Lawyer Services Today

PERSONAL INFORMATION
*Name:
*Address 1:
Address 2:
*City:
*County:
*Zipcode:
*Telephone Number:

ACCUSATION DETAILS
What are you accused of:
I was given the following tests to determine if I was intoxicated:	Field sobriety tests (walking a straight line, balancing, reciting the alphabet, etc.)
	Blood, breath or urine sample at the police station
The test showed my blood alcohol level was:
The Number of previous times you have been convicted or pled guilty to drunk driving / DWI / DUI:

ARREST DETAILS
Date of arrest / citation:	(MM-DD-YYYY)
Date of next court appearance:	(MM-DD-YYYY)
Where were you charged:
I know the names and locations of witnesses to the arrest:	Yes No Not Applicable

PERSONAL DETAILS
Are you currently on probation:	Yes No
Sex:	Male Female
Age:
Citizenship or Residency Status:	US Citizen Resident Alien Other

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