Eash Law, P.C.

114 South Main Street
Middlebury, IN 46540

(574) 825-9665

Please fill out the following form so we can better understand the type of court action you are looking to take.

Contact information: Your Information

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First name *

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Addresses

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Opposing Party Information

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Injury or Wrong Committed

This section will cover the injury or wrong you believe you have suffered. Fill out as much information as possible.

What was the date this injury took place?

What type of litigation do you anticipate filing in this cause?

NegligenceIntentional Infliction of Emotional DistressInvasion of PrivacyTrespassingAssault / BatteryDefamationNegligent Infliction of Emotional DistressProduct Liability ClaimHOA Violations Against HomeownersCivil Rights ViolationsPersonal InjuryMedical MalpracticeProperty DisputeBreach of Contract LitigationTortious Interference with a business relationshipViolations by Law EnforcementOther (please describe below)

Please provide a description of the wrong you suffered providing as much detail as you can including dates, times, evidence you plan to present, etc.

Do you have any supporting documentation you would like to provide to our office? If so, please upload here.

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