Unit 1 Assignment_Bianca Carroll.doc - Initial Client...

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Initial Client Interview Form A. CLIENT PERSONAL INFORMATIONName: Justin KingAddress: 123 Main Street, Chicago, Illinois 60601Home Phone: (913)123-4567Work Phone: (913)890-1234Social Security Number: 123-45-6789Driver’s License Number: IL39562243Date of Birth: 7/14/83Marital Status: SingleDependents: NoneMilitary Status: N/AOccupation: Student/RetailEmployer Name, Address, Phone Number: __________________________________________________________ Membership in Union or Professional Organization: N/A Police Record (if any): N/AHave you ever filed bankruptcy? If so, please explain. N/AB. CLIENT EMPLOYMENTType of Work: Retail SalesJob Title: CashierImmediate Supervisor’s Name: Jill JanesSalary or Hourly Rate: $7.75/hourNumber of Hours Worked Weekly - Before Accident 20- After Accident 0
Benefits (Company car, pension plan, vacation, expense account, etc.) N/A D. CLIENT’S FACTS/STORY: BE AS DETAILED AS YOU CAN BE. INCLUDE DAMAGES AND ALL NAMES TOLD BY CLIENT Justin King first starts off by saying that he was injured in an automobile accident. When prompted to verify his address he states it as 123 Main Street Kansas City, Missouri. Justin King states that he wasa singer and won the National Idol regional contest in Chicago on April 5thof last year in which they gave him a contract with MCI records but

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