Mears Law Intake Form
Please Note: The information in this form, including photo identification, is required by the Law Society By-Laws regarding Client Information. By completing and submitting this form you are consenting to provide us personal information about yourself. Completing and submitting this form does not create a Lawyer/Client relationship. The Lawyer/Client relationship begins when you complete our retainer agreement.
First Name
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Middle Name
Last Name
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Email
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Primary Telephone No
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Secondary Telephone No (If Applicable)
Address
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City, Town or Village
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Apt No.
Province
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Postal Code
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Job title
Employer
If you are seeking legal representation on behalf of corporation, please state the name of the corporation
Do you have legal authority to bind the corporation
Yes
No
Service of Interest
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Artificial Intelligence
Corporate
Dispute Resolution
Immigration
Privacy and Data Protection
Real Estate
What is the issue that you want legal representation for? Do not include personal or sensitive information in this form.
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Have court proceedings commenced?
Yes
No
Court File #
We will request that you provide us with a copy of your ID. What type of Photo ID do you intend to provide to verify your identity.
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Driver's License
Passport
Other Government Issued ID
Upload a copy of your valid Photo ID
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ID Number:
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ID Expiration Date:
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Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
How did you hear about us?
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Employer Referral
Friend or Family
Former Client
Internet
JusticeNet
Law Society
Lawyer Referral
Mortgage Broker
Realtor
Social Media
Other
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Please list the names of all other parties involved in your matter
The following questions must be answered if your matter involves another party. If you are entering into an agreement include the individuals you are contracting with. If your matter only involves you or your company please answer not applicable. The information provided is required to conduct a conflict of interest search. Failure to disclose information on additional parties may result in the cancellation of your appointment so that conflict checks can be conducted.
Name(s)
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Former Name(s)
Nickname(s)
Other Name(s) used
Corporate client: List your shareholders
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Corporate client: List your Officers or Directors
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Corporate client: List your parent Corporation or subsidiaries (if applicable)
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Corporate client: List your partners of affiliates (if applicable)
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If you are an individual: List the name of your spouse or any close relative and any person associated with you (if applicable)
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If you have a major interest in a law firm or other organization please list the members of the law firm or organization.
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I hereby authorize Mears Law Professional Corporation
to communicate with me through the e-mail address provided above and state that the contents of this form are true to the best of my knowledge.
Client Signature. Please type your name below.
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Date
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