Step 1 of 128%If you are inquiring about a family law issue (divorce, paternity, custody/visitation, support), please call our intake line at 312-332-1624. We cannot accept family law requests online and will not reply to family law issues submitted with this form.Terms of UseBy using this application you are asking for legal help in Illinois. Our staff will use the information you give to see if you qualify. We cannot accept every case and you are not our client unless we tell you that your case has been accepted. We are not responsible if your application is not received due to server or internet problems. I AgreeDeadline DisclaimerIf your need for legal assistance has a short deadline (28 days or less) do not apply online. Instead, contact CVLS by phone or in person. Visit the contact page for our address, hours of operation, and phone number. I AgreeEligibility Requirements1. Income Disclaimer Chicago Volunteer Legal Services’ services are FREE. We determine financial eligibility for legal services based on the income and asset information of EVERY person in the household, using Federal Poverty Income Guidelines. 2. Case Type Disclaimer We do not accept criminal, personal injury, traffic court, or other fee generating matters. 3. Conflicts Disclaimer If you know or think that Chicago Volunteer Legal Services has talked to the opposing party in your legal matter, do not apply online. Instead call (312) 332-1624 to find out if there is a conflict of interest. I AgreePrivacy DisclaimerAs a prospective client of Chicago Volunteer Legal Services, the information you provide to us will be treated as confidential and we will not disclose your information without your consent or prior notice. We will use the information you provide in the application only to determine your eligibility for services. I AgreePersonal InformationName* First Last Date of Birth* MM slash DD slash YYYY Last 4 Digits of Social Security NumberPhone*Email* Zip Code*Incarceration* Yes NoHave you or your family been impacted in any way by incarcerationMilitary Service* Yes NoHave you ever served in the military?Family Military ServiceNoneSpouseChildParentSiblingGrandchildGrandparentOtherIf a member of your immediate family has served in the military, provide all relationships.Summary of Legal Problem*Please describe your legal issue. Include any additional information about your legal matter. Include any scheduled court hearings, case numbers, and list any documents or paperwork that you may haveOpposing Party*Please provide the name of the person or company with whom you are having a legal problem.Household SizeInclude yourself and anyone you are legally obligated to support and anyone who is legally obligated to support you. - Do not include a boyfriend or girlfriend, even if you live together - Do not include any children age 18 or older, even if they live with you - Do not include any children that are not yours, even if they live with you - If you are the victim of domestic violence and are seeking to flee abuse, do not include the abuser in your household - If you are currently going through a divorce, do not count your spouse in your householdNumber of Adults*Number of Children*Work IncomePlease enter the amount earned each month. For each line, add the total dollars for your household. Enter 0 if no one in your household earns this kind of income.Self-employed or farming income ($)*Government BenefitsPlease enter the amount earned each month. For each line, add the total dollars for your household. Enter 0 if no one in your household earns this kind of income.TANF or other cash assistance from DHS ($)*Veteran's benefits, including veteran's disability payments ($)*Unemployment benefits ($)*Social Security, including retirement and disability benefits ($)*SSI ($)*Additional IncomePlease enter the amount earned each month. For each line, add the total dollars for your household. Enter 0 if no one in your household earns this kind of income.Private insurance or disability payments ($)*Alimony or spousal support ($)*Child support ($)*Worker's Compensation ($)*Pension or 401(k) retirement benefits ($)*Investment income such as money from property or real estate, stocks or bonds ($)*Other IncomeDo you have any income from other sources? Add the total dollars from your household. Enter 0 if your household doesn't have any other income.Other Income ($)*CallbackAfter reviewing your submission, we will determine if you are eligible for our services. If eligible, we will contact you at your selected time on the next work week by telephone. Applications received on Saturday or Sunday, or when your callback time falls on a holiday, will be responded to on the second work week from the date of submission. If we are unable to reach you by telephone during your scheduled callback time, we will close your application. Any future requests for service may only be done through our telephone intake at 312-332-1624. Additional online applications will not be accepted. If you are not eligible, you will receive an email explaining our denial of service. Please select when the best time for your callback would be.Callback Time Tuesday 1:00 - 4:30 pm Friday 1:00 - 3:30 pm