Justin King Client Interview

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Initial Client Interview Form A. CLIENT PERSONAL INFORMATION Name: Justin King Address: 123 Main Street, Chicago, Illinois 60601 Home Phone: (913)123-4567 Work Phone: (913)890-1234 Social Security Number: 123-45-6789 Driver’s License Number: IL39562243 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 Justin King was in an automobile accident on or about April 8th, about three days after winning the National Idol Singing Contest. He had signed a three year contract for $275,000 a year with MCI Records in Chicago. The accident took place on Interstate 57 on his way back from his agents office. Justin was on a motorcycle, in the left hand lane going about 60-65 MPH. A Beer truck (Coops, Coops Light, Coops Ultra; Justin doesn't quite remember the name on the truck) came behind him, wanting to pass. He moved over to the right once he saw the flashing lights. Justin swerved over to the left when a couple of cases of beer came off the beer truck. The next thing he knew, he was in the emergency room in Paxton. He spent 2 days in the ER and had broken 9 facial bones and

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