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Kessler & Solomiany, LLC > Client Intake Form

Client Intake Form

"*" indicates required fields

Date*
Full Name*
Confidential/Secure Address*
Date of Birth*

Contact Info (we strongly suggest that you create a new email address with secured password for communication with our firm)

Date of Marriage*
Separation Date*

Adverse Party Information

Minor Children

INITIAL CONULTATION FEE DUE PRIOR TO START OF THE INITIAL CONSULTATION No representation is provided until a signed fee contract is received and Retainer is paid