NLG-LA Intake Form: Mass Protest Defense

NLG-LA Intake Form: Mass Protest Defense
We thank you for your courage in taking a stand against racist and oppressive systems and exercising your First Amendment rights to help create a more just society.

If you were arrested, cited, or ticketed for your participation in any social justice protests in the Los Angeles area, the NLG-LA's Mass Defense Committee (MDC) is here to support you through navigating the legal system post-arrest and help alleviate any confusion and anxiety you may have about what comes next.

Please note: We will not be able to assist you if your court date is less than two weeks after the date you fill out this form.

CONFIDENTIALITY: Maintaining confidentiality is of critical importance to the MDC. The information you provide in this form and through our intake interview will always be kept confidential and shall not be disclosed other than to NLG-LA employees, NLG-LA agents, NLG-LA attorneys, other NLG-LA volunteers (collectively, "Representatives") who need to know such Confidential Information to provide legal support services and/or pro bono legal representation.

STATUTE OF LIMITATIONS (i.e. deadline) - You may have a civil rights lawsuit for damages if your constitutional rights were violated by law enforcement and/or you suffered injuries as a result of an arrest or use of force by law enforcement. To protect your state law rights to claim damages, you must file a claim with the responsible government agency within six months of the violation of your rights. You do not have to submit a pre-filing claim to protect your federal civil rights.

Submitting an intake form does not equate guaranteed representation.
Were you arrested at a protest?*

YesNo
Legal Name*

First NameLast Name
Chosen Name (if different from Legal Name above)
Pronouns
Email*
example@example.com
Phone*
Date of Birth*

MonthDayYear
Date
Court Date (If no court date, please put today's date) *

MonthDayYear
Date
Which Court? (If this doesn't apply to your situation simply write N/A) *
Date of Arrest or Incident*

MonthDayYear
Date
City of Arrest or Incident*
Law Enforcement Agency Involved

Los Angeles Police DepartmentLos Angeles County Sheriff's DepartmentSanta Monica Police DepartmentLong Beach Police DepartmentOther
See pictures below to determine if you received a citation or a release slip

Sample release slip with charge information circled in red

Sample citation with charge information circled in red

Sample citation with citation number circled in red
Charge(s) Listed on Your Citation or Release Slip (*If you weren't charged with anything simply write N/A) *
Citation Number (The number listed on the upper corner of your ticket)
Time of Arrest

Hour Minutes

AM/PM Option
Time of Release

Hour Minutes

AM/PM Option
What happened after your arrest?

I was given a citation or ticket at the action and released (not transported anywhere)I was transported to a police station or jail, given a citation, and releasedI was booked into jail custody (e.g fingerprint/mugshot) & released without posting bailI was booked into jail custody & had to post bail to be releasedI was booked into jail custody & held without the option to post bail for my releaseOther
If you were assigned a bail amount, how much was it?
How did you pay for your bail?

Paid out of pocketSurety Bond from bail bond companyCommunity bail fundCould not post bail amountOther
Were you injured or subjected to excessive police force? If so, please briefly describe.
Did you witness any illegal or concerning conduct by law enforcement during this action that we should be aware of? (please provide any identifying information including officer names and badge numbers)
Do you need legal support for a specific protest related issue other than your arrest/citation/ticket? (e.g. illegal vehicle impoundment; parking tickets from a car caravan; police harassment or intimidation; etc)
I understand that NLG LA's attorney network is made up entirely of volunteer attorneys and submitting a request for pro bono representation does not guarantee that NLG LA will be able to match me with an attorney.*

Clear
I understand that it is my responsibility to attend my scheduled court date in person and that NLG LA cannot provide a lawyer to attend on my behalf if I am out of town.*

Clear
INTAKE INTERVIEW: We will reach out to you within a few weeks to schedule your follow up intake interview. If you do not hear from us within 6 weeks, please contact Rebecca@nlg-la.org.

PRO BONO REPRESENTATION: We will reach back out to you approximately 4 weeks before your court date to update you on the status of your request for pro bono representation. If we are able to find you a pro bono attorney, we will connect you to the attorney at that time. If we are unable to find an attorney who can represent you pro bono, you still have the option of getting an attorney for free through the Los Angeles Public Defender's Office or retaining private counsel.
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