APPLICATION FOR LEGAL SERVICES

Application for Legal Services

Disclaimers

Disclaimers

*The Village Legal and Community Project provides Free and Sliding Scale legal services in Illinois. We collect financial information to determine eligibility for our services. Eligibility is determined by Federal Poverty Income Guidelines. You agree to provide income and asset information for every household member.

I Agree

*The Village Legal and Community Project provides civil legal services. We do not accept personal injury, traffic, or criminal defense matters. By submitting an online inquiry for help, you understand that we cannot accept all cases and no attorney/client relationship is created unless we communicate that we accept your matter.

I Agree

*Any information provided to The Village Legal and Community Project is confidential and will not be disclosed without your consent or prior notice. The information you provide is used to determine your eligibility for services.

I Agree

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*First Name

*Last Name

*Date of Birth

*Last 4 Digits of your Social Security Number

*Street Address

*City

*State

*Zip Code

*Phone

*Email

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Number of Household Members

*Which option best describes your race/ethnicity?

*Please describe the legal matter:

Name of opposing party, if applicable.

Number Household Members

Number of Household Members

Over 18 years of age

Under 18 years of age

Household Income

Household Income

Source(s) of Income (must be able to provide proof)

Please outline below sources of income:

Employment (source, frequency, amount)

Unemployment Benefits (source, frequency, amount)

Social Security (disability & retirement) (source, frequency, amount)

SSI (source, frequency, amount)

TANF or other assistance from DHS (source, frequency, amount)

Veteran’s benefits (source, frequency, amount)

Alimony (source, frequency, amount)

Child Support (source, frequency, amount)

Worker's Comp (source, frequency, amount)

Pension (source, frequency, amount)

Investment Income (source, frequency, amount)

Other Sources Not Listed

CONNECT WITH US

5113 S. Harper Suite 2C

Chicago, Illinois 60615

Phone: +773-234-0027

Email: info@tvlcp.org

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