Client Intake – Wiseberg Law

Will the client(s) be an individual(s) or a corporation(s)?*

How many Clients are there?*

One
Two

If there are more than two clients, please check "Two", fill in the form, and fill in the information requested below for additional clients under the heading "More Than Two Clients."

What is the name of the Corporation?*

Articles of Incorporation

Max. file size: 2 MB.

You will need to to provide us with your articles of incorporation

If there are more than two corporations, please provide the name of the additional corporation(s) and your relationship to them.

Is the client(s) acting through a third party?*

Yes
No

Click yes if you are acting as an agent, trustee, attorney under a power of attorney, guardian, or in any other situation in which you are representing the the person who will be the client.

If the client is acting through an agent, through a trustee, under a power of attorney, through a guardian, or in any other situation in which the client will be represented by another, please provide the name, date of birth, address and contact information of the client.

Tell Us About You

Name*

Prefix First Middle Last

What is your relationship to the Corporation (choose all that apply)

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone (Cell)*

If you do not have a cell phone, please write down the number where we can reach you.

Phone (Home)

Phone (International)

Email*

Enter Email Confirm Email

Occupation*

Name of employer*

Phone (Work)*

Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Client Two - Tell Us About You

Client 2 - Name*

Prefix First Middle Last

Client 2 - Date of Birth*

Client 2 - Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Client 2 - Phone (Cell)*

If you do not have a cell phone, please write down the number where we can reach you.

Client 2 - Phone (Home)

Client 2 - Phone (International)

Client 2 - Email*

Enter Email Confirm Email

Client 2 - Occupation*

Client 2 - Name of employer*

Client 2 - Phone (Work)*

Client 2 - Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

More Than Two Clients

If there are more than two clients, please write down the name of each additional party, the date of birth of each additional party, the address of each additional party, the phone number of each additional party, the email address of each additional party, the occupation of each additional party. the name of each additional party's employer and the business address of each additional party.

Identification

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 2 MB.

Please provide two (2) pieces of identification for each party, front and back, with one (or both) of those pieces of identification being a driver's license and/or a passport. If providing only one of a passport or a driver's license, the other piece of identification need not be a picture id, and cannot be a health card.

CLIENT INTAKE FORM

Client Intake - General

Tell Us About You

Client Two - Tell Us About You

More Than Two Clients

Identification