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Please complete this interview as completely as possible. It will be used to evaluate your case and to determine case strategy should you decide to attend a free office visit. This interview form will remain confidential but this does not establish an attorney client relationship.

Your Name

Your Address

Your Email

Your Telephone numbers (Home/Business/Mobile/Pager)

Your Age

Service in armed forces   YesNo

Where do you work and what do you do there?

What is your marital status?

The Arrest

Date of Arrest

Time of Arrest

Place of arrest and reason for initial stop

List the name of all of the officers involved (arresting officer, officer conducting field sobriety test, officer conducting horizontal gaze nystagmus test, and the officer conducting the breath test)

If you took the online breath test what were your results
You can take it now by clicking here. Just close the windows afterwards to return here.

What were you doing in the hours before your arrest? Please including anything you said to the police officer(s) and what the police officer(s) said to you. Please supply as much detail as possible.

Were Miranda warnings given to you?

Did you speak to anyone other than the police? If so, what did you say?

Were you given any field sobriety, or coordination tests (walk-the-line, heel-to-toe, finger-to-nose, stand-on-one leg, recitation of the alphabet, etc.)? If so, what tests, when and where were they given? How do you feel you did with respect to each test? If you refused to take any of these tests, were you told what would happen?

At the time of the arrest, did you take a Breath Test? If so, what was the result?

How much sleep had you had 24 hours prior to the tests?

Were you or your vehicle searched? Were you asked for permission to search? What was found?

Did you consider yourself to be impaired?

Consumption prior to arrest:

Time of last drink    

I had over a period of hour(s).

What had you eaten?

Names, addresses and phone numbers of all persons who were with you while you were drinking or when you were stopped. Would they be willing to testify on your behalf? What do you believe they would say?

Did you drink any alcohol after this incident began?

Vehicle Information

What are the make, year, and model?

Prior DUIs

Do you have any prior DUIs?

Are you on probation? If so, what for, what are the terms of probation?

Other Information

Is there any other information that you feel is important?

DISCLAIMER:   The foregoing is not to be construed as legal advice to or for any specific individual. Always seek the advice of counsel for specific legal problems. The submission of this does not establish an attorney client relationship.


You should print the next screen to keep for your own records.


Please submit all questions and comments to:
Law Office of Board Certified Criminal Trial Lawyer
W. F. "Casey" Ebsary, Jr.
1101 Channelside Drive Suite 244
Tampa FL 33602
813.222.2220
P.O. Box 1550
Tampa FL 33601
813.225.0202*(FAX)
* NOTICE: The publication of our fax number on this web sites is not to be construed as the firm's consent to received unsolicited fax advertisements, nor does it create an Existing Business Relationship (EBR).

Copyright © 2001, Copyright © 2002, Copyright © 2003, Copyright © 2004, Copyright © 2005, Copyright © 2006, Copyright © 2007, Copyright © 2008
The Law Office of W. F."Casey" Ebsary, Jr., Board Certified Criminal Trial Lawyer
All rights reserved.

Last revision:  June 29, 2008

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