Intake Form


Complete the MVLP's Intake Form below. If you qualify, MVLP will contact you for additional information.

MVLP currently assists clients with civil legal matters, primarily in the following areas: uncontested divorces, emancipations, simple wills, adoptions, guardianships, name changes, birth certificate corrections, conservatorships, and felony expungement matters.

MVLP DOES NOT HANDLE CRIMINAL MATTERS.


ROUND TO THE NEAREST DOLLAR WHEN RESPONDING TO FINANCIAL INFORMATION. (e.g. $500.00 should be 500). FAILURE TO ROUND TO THE NEAREST DOLLAR WILL RESULT IN YOUR FORM NOT BEING PROCESSED.

What is your legal matter? (Select an option below)

 

Divorce

 

Felony Expungement

 

If you are currently incarcerated, you are unable to receive an expungement. Please wait until after you have completed the terms of your sentence.
If you are currently incarcerated, you are unable to receive an expungement. Please wait until after you have completed the terms of your sentence.

 


 


 

Guardianship

 




Household Monthly Income Detail

 


Household Monthly Expenses

 


Statement of Facts

 


Retainer Agreement

I hereby request that the Mississippi Volunteer Lawyers Project (MVLP) represent me and do hereby certify that I do not have enough money or property to hire a private lawyer. I will promptly tell MVLP of any change in my address, telephone number, income, or household size. I have provided MVLP with valid, true and correct verification of my income. I understand that I will be able to continue receiving services from MVLP as long as my income and assets are at or below the established eligibility guidelines, otherwise, MVLP might have to end this agreement and stop representing me.

I understand that MVLP does not charge legal fees for its services, but that I am responsible for paying a filing fee to the volunteer attorney who handles my case if MVLP is able to locate one for me. I understand that I may also be responsible for paying service of process fees, publication fees, special master fees, guardian ad litem fees and any other fees that may be incurred during the course of MVLP’s handling of my case to my volunteer attorney. I agree that I will not settle my case or problem without first informing MVLP. I will not communicate with any other person, agency, organization, or institution about my problem after MVLP has agreed to accept my case unless MVLP tells me that it okay to do so.

I understand that MVLP will work vigorously on my behalf and will keep me regularly informed about the status of my case. I agree to cooperate with and assist MVLP in my case, including and not limited to providing complete and truthful information when requested, being present at all scheduled hearings and meetings, and responding promptly to phone calls and letters from MVLP.

I acknowledge that I understand the terms of this agreement, and have been given an opportunity to ask questions and receive an explanation regarding any part of it I did not understand. It is understood and agreed that this agreement is only valid when signed by both parties (the client and MVLP representative). A staff member may need the approval of his/her immediate supervisor before MVLP can accept my case and sign this agreement. This writing represents the entire agreement between the parties and cannot be amended or modified except in writing signed by both parties.

I have read the above information and it is a true and accurate statement of my financial situation and the facts concerning my problem. I certify that I am a citizen of the United States of America.