W.J. Helzlsouer - Attorney at Law W.J. Helzlsouer - Attorney at Law
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STADIUM LITIGATION QUESTIONNAIRE

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This Questionnaire is for gathering information in regard to the lawsuit filed in the court of common please at No. GD 01-016041. Please be as complete as possible.
First Name:
Last Name:
Middle Initial:
Address:
City:
State:
Zip:
Phone:
Facsimile:
Email:
SBL Holder Name (exact licensee name on the account):
SBL Account No:
SBL Application No:
Selections Requested on SBL Application:


(1st Choice)
(2nd Choice)
(3rd Choice)
SBL Section Assigned To You As Indicated On Your SBL Agreement:
A B C Club 1
D E F Club 2

SBL Section Where You Believe To Actually Be Located:
A B C Club 1
D E F Club 2
Number of Seats:
Actual Seat Location(s):
Section no(s):
Row no(s):
Seat no(s):
Season Ticket Holder:
Yes      No
Years as a ticket holder:
Previous Seat Location(s):
Section no(s):
Row no(s):
Seat no(s):
Total Amount Paid for SBL:
Amount Overcharged (if known):
Comments and explanation of claim:


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Address and Contact Information