Become a Client

Clients are interviewed to determine eligibility, and their legal issues are evaluated on a case-by-case basis. Please complete the intake sheet below to have your case evaluated, after which we will contact you.


Name/Nombre Last Name/Apellido

DOB /Fecha de Nacimiento: month/mes day/día year/Año

Place of Birth/Lugar de Nacimiento Marital status/Estado Civil:

Social Security #/ Número de Seguro Social Gender/Género: MaleFemale

Race: Native AmericanHispanicWhite(not Hispanic)Black(not Hispanic)Asian

Disable?/Desabilitado? Yes/SiNo Veteran?/Veterano? Yes/SiNo Migrant?/Inmigrante? Yes/SiNo

Victim of Domestic Violence?/Victima de Violencia Doméstica

Phone #/Numero de teléfono E-Mail/correo electrónico

Residence address/Dirección donde reside:

Zip Code

Mailing address /Recibo correspondencia en:

Living Situation: ownrentliving facilityshelterothers Explain:

Do you consider your household income within 125% of the federal poverty level or less? YesNo
Please refer to the chart below.

Household Size Week Month Year Other income/frecuency
1 309 1,238 14,850
2 417 1,669 20,025
3 525 2,100 25,200
4 633 2,531 30,375
5 741 2,963 35,550
6 848 3,394 40,725
7 957 3,826 45,913
8 1065 4,260 51,113

Please explain source:

Adverse Party Information (If there is any)/Información de parte contraria (si existiera)



Phone #/teléfono:

Yes, I attest that the personal and financial information that I provided is true and accurate/Afirmo que la información personal y financiera que he proveído es cierta.

  • Call our office during our hours of operation: Monday through Friday 9 a.m. to 5 p.m.

Note: Our office hours are Monday through Friday 9 a.m. to 5 p.m. Please bring with you any proof of income so that we may qualify you for our program. Such proof of income, may include, but shall not be limited to, a copy of income taxes for the current year, last month of pay stubs, and letters evidencing receipt of social security retirement or disability benefits, all as applicable.

Additional Resources

Lesley Mendoza, Executive Director
CABA Pro Bono Legal Services
2400 South Dixie Highway
Miami, FL 33133

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