Law Firm Pro Bono Reporting Form

www.dadelegalaid.org

(305) 579-5733
Law Firm Pro Bono Reporting Form

2024
Please complete the form below and include all of the cases the firm handled or completed in 2023-2024 in order to be included in our circuit report.

Thank you!

Stephanie Grosman, Esq.
Law Firm Coordinator
Law Firm Name*
Pro Bono Coordinator*

First NameLast Name
E-mail*
example@example.com

Please fill out information below.

	Attorney Name	Bar#	Client Name	Type of Case	Date Opened	Date Closed	Pending	Closing Code
1
2
3
4
5
6
7
8
9
10

Please attach any additional documentation regarding your firm's Pro Bono hours. Thank you for your participation in Put Something Back.

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Should you have any questions, please contact Stephanie Grosman at sgrosman@dadelegalaid.org
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