Attorney ProfileOffice LocationContact Me

CONTACT THE ATTORNEY
Phone 321.757.6848
-OR-
321.750.1107
( after-hours )
Email E-Mail Mr. Golub
Form Request Legal Help



Submit information about your criminal case and your initial consultation will be free!

 

 

 

 

 


PERSONAL INFORMATION

First Name:

Date of Birth:

Last Name:

E-Mail:

Street Address:

City, State:

Cont'd.:

Zip:

Home Phone:

Cell Phone:

EMPLOYMENT INFORMATION

Employer:

Job Title:

Work Phone:

How would you prefer to be contacted?

Work Phone
Home Phone

Cell Phone
E-Mail

DETAILED REQUEST INFORMATION

Briefly explain what you may need advice about or assistance with:

Do you have a court date? Where is it and when?

How did you find our website?