Please note that there will be a 4% online payment surcharge added to your transaction.
Note: To avoid DOUBLE PAYMENT, please do NOT hit the back button or submit more than once. Please wait for the confirmation message to show.
Please print out the entire questionnaire, fill out completely, and then mail or fax the completed questionnaire, along with a money order or pay online for $300.00 (Personal check not accepted)
PLEASE DO NOT:
ANSWER THE QUESTIONNAIRE ON LINE OR E-MAIL QUESTIONS TO US.
Law Offices of Michael J. Gurfinkel, Inc. 219 North Brand Boulevard Glendale, CA 91203-2609 Attention: In-Take Department
If you wish to print out the questionnaire from our website in pdf format, Click here