CASE CLOSING FORM - July 2016+

Full Representation Case Closing Form

Dear Volunteer Attorney,

Thank you for your work to fulfill one of our society's most basic promises
- Equal Justice Under Law!

We also appreciate your time in telling us what you did and the results of your work. This form should take about five minutes to complete. (It can also be completed on a phone.) The information you provide is essential for us to a) make sound programmatic decisions and b) provide compelling reasons to potential and ongoing funders.

Thank you, from the board and staff of VLN.

Attorney Name*

First Name*

Last Name*

Law Firm Name

Other Ballard Spahr LLP Bassford Remele Best & Flanagan LLP Dorsey & Whitney LLP Faegre Drinker Biddle & Reath LLP Fox Rothschild LLP Fredrikson & Byron, P.A. Larkin Hoffman Daly & Lindgren Ltd. Lathrop GPM Lind, Jensen, Sullivan & Peterson, P.A. Maslon LLP Merchant & Gould P.C. Nilan Johnson Lewis, P.A. Robins Kaplan LLP Stinson LLP Taft Stettinius & Hollister LLP None

Law Firm Name

Would you like an email copy of the information you provide below?*

Yes No

Would you like information about how you may claim CLE credit for pro bono work through VLN?*

Yes No

Your email address:*

Client Name*

First Name*

Last Name*

When a case is concluded, we contact the client to obtain follow up information critical to our funders. Please help us with this by telling us how you and your client communicated (or, any updates to their contact information). Please check all that apply.

By email By phone By mail

Other: Other Value

What is the client's email address that you used?

Confirm What is the client's email address that you used? *

What phone number(s) did you use? If you believe it would put the client at risk for us to call him or her, please put N/A.

What mailing address did you use?

Address Line 1

Address Line 2

City

State

ZIP Code

How else did you contact the client?

Is your client a resident of Hennepin County?*

Yes No Not sure

Type of case*

Bankruptcy Civil Criminal Expungement Family Landlord/Tenant Letters to Creditors Real Estate Other

"Other" case types*

Administrative (NOT UC) Birth Certificate Employment (usually wages) Immigration Unemployment Compensation Tax Other

Was the service provided at a clinic?*

Yes No

Hours You Volunteered (May be counted towards CLE requirements.)*

Please check the type of work you did during those hours (please check all that apply)*

Advised client in person Advised client by phone Recommended various settlement options Negotiated with opposing party Drafted motions and/or pleadings Filed motions and/or pleadings (including bankruptcy) Attended court hearings Drafted court orders Wrote letter(s) on client's behalf Made phone calls on client's behalf Represented client in an uncontested court hearing/trial

Other: Other Value

Please check the type of work you did during those hours (please check all that apply)*

Legal advice Brief service, such as writing a letter or making a phone call to a third party on client's behalf Resolved an issue through negotiation Resolved a court case through negotiation Represented client in an uncontested court hearing/trial Represented client in a contested court hearing or trial Other extended services (includes extensive research, preparation of complex legal documents, extensive interaction with third parties) No legal services provided to client

Other: Other Value

Additional volunteers (including mentors) and hours they volunteered

Did you complete the service to the client?*

Yes No, the client or I withdrew before my services were completed

After when did your services end?*

The client and I never connected The client and I connected and I gave some advice We connected and I completed some paperwork We connected and I made a phone call to a third party on client's behalf We connected and I represented the client in some hearings

Other: Other Value

Was completed paperwork given to the client?*

Yes No

Other: Other Value

Did the client let you know he or she did not wish to pursue full representation.*

Yes No

Other: Other Value

Please provide a few details.*

In what calendar year did your services end?*

before 2022 2022 2023 2024

Type of family law case*

Divorce without children Divorce with children Custody Adoption

Other: Other Value

If applicable, please list the amount of any settlement:

The case is*

District court: pre-judgement District court: post-judgment (and Garnishment Defense) Conciliation court appeal to district court

Type of pre-judgement issue*

Car Title Debt Collections Lawsuit Uninsured Car Crash Lawsuit Other

Type of post-judgment issue*

Garnishment defense Motion to vacate default judgment Financial Disclosure Form completion Judgment collections ($ owed to client) Other

BANKRUPTCY: What best describes the service you provided?*

Obtained discharge Brief services (letters, phone calls) Legal advice Referred after legal assessment Insufficient merit to proceed Attorney or client withdrew before end of service

Other: Other Value

Letters to Creditors: What best describes the service you provided (select one)?*

Sent letters to client's creditors Brief service (one round of letters and one month follow up work only) Legal advice Attorney or client withdrew prior to any service

Other: Other Value

LANDLORD/TENANT: What best describes the client's issue?*

Eviction Tenant remedy/repairs Expungement Security deposit

Other: Other Value

TENANT REMEDY/REPAIRS: Were any repairs made? If yes, what type of repairs?*

TENANT REMEDY/REPAIRS: Was an early lease termination negotiated?*

Yes No

EVICTION: Did you win, lose or settle this case? *

Won Lost Settled Other

A win is a court order in favor of your client. A loss is a court order in favor of the opposing party. A settlement is any a settlement agreement between the parties.

EVICTION: Please describe the "other" result:*

EVICTION: Was a writ ultimately issued?*

Yes No Unknown/still possible

EVICTION: Was the case expunged or concealed by the court? Check all that apply*

Eviction expunged Caption changed Case made confidential Settlement agreement provided for future expungement/confidentiality/caption change No Other

EVICTION: Please explain the "other" result:*

Car title: result of representation

Obtained Car Title [802] Obtained Other Benefit [9901]

Other: Other Value

Collections lawsuit: result of representation

Prevented civil judgment on merits [230] Prevented judgment by default by serving answer [232] Obtained dismissal of lawsuit without prejudice [237] Obtained other benefit [9901]

Other: Other Value

Other civil lawsuit: result of representation

Prevented civil judgment on merits [230] Prevented judgment by default by serving answer [232] Obtained dismissal of lawsuit without prejudice [237] Obtained other benefit [9901]

Other: Other Value

Conciliation Court Appeals: result of representation

Appeal won Appeal lost Some issues won, some issues lost

Details

Uninsured car crash lawsuit: result of representation

Prevented judgment in uninsured auto accident case on merits [231] Prevented auto accident judgment by default by serving answer [233] Obtained dismissal of lawsuit without prejudice [237]

Other: Other Value

Motion to vacate default judgment: result of representation

Re-opened default judgment [234] Prevented civil judgment on the merits [230] Obtained dismissal of lawsuit without prejudice [237]

Other: Other Value

Civil case results (please check all that apply)

The client is now in a payment plan to lift an existing suspension of drivers license The client is now in a payment plan to prevent a suspension of drivers license A garnishment was prevented A garnishment was lifted Previously garnished funds were returned to the client

Other: Other Value

Criminal expungement: result of representation

Obtained expungement of all government-held records [8902] Obtained expungement of some government-held records [8903] Lost on merits, advised client on next steps. [9901]

Other: Other Value

Of STATUTORY cases, which records were expunged?

District court BCA Other executive agencies None N/A (there were no statutory cases)

Of INHERENT AUTHORITY cases, which records were expunged?

District court BCA Other executive agencies None N/A (no cases were brought under inherent authority)

Details (including what could help us in screening future cases)

Administrative law outcomes (please check all that apply)

Preserved client's current job Preserved client's employment-related license Reinstated client's employment-related license Preserved client's educational opportunities Increased client's educational opportunities

Other: Other Value

Birth certificate: result of representation

Obtained birth certificate [8911]

Other: Other Value

Letters to creditors: result of representation

Stopped debt collection harassment and recovered exempt income Stopped debt collection harassment

Other: Other Value

Letters to creditors results (please select one)

Stopped all harassing phone calls Stopped some harassing phone calls Did not stop harassing phone calls

Other: Other Value

Employment: result of representation

Obtained wages due Prevented wrongful discharge

Other: Other Value

Employment other results (please check all that apply)

preserved client's employment preserved health insurance preserved other employment benefits

Other: Other Value

What is client's hourly wage?

What was the amount of the collected wages?

UC: result of representation

Preserved/obtained/increased UC benefits for client

Other: Other Value

Landlord/tenant - Eviction: result of representation

Client can remain in premises (eviction prevented) [6301] Client will vacate by a date certain Client evicted

Other: Other Value

How many days does the client have to vacate?

Without your representation, how many days would the client have had to vacate?

Was the eviction expunged?

Yes No

Other: Other Value

Landlord/Tenant - Repairs: result of representation

Landlord to make repairs and client’s rent abated Landlord to make repairs but client's rent not abated Landlord not to make repairs

Other: Other Value

Landlord/Tenant - UD Expungement: result of representation

Record expunged [6309] Record not expunged

Other: Other Value

Landlord/Tenant - Security Deposit: result of representation

Return of full security deposit Return of partial security deposit No return of security deposit

Other: Other Value

Divorce case results (please check all that apply)

Divorce obtained [3201] OFP obtained regarding spouse [3701] Homestead - awarded Pension account - portion awarded Pension account - preserved Maintenance - preserved Maintenance - obtained Maintenance - modified Legal separation obtained

Other: Other Value

Divorce case results re: children (please check all that apply)

Physical custody - obtained [3202] Physical custody - preserved [3202] Right to parental access - obtained [3203] Right to parental access - preserved [3203] Child support - obtained [3801] Child support - preserved [3801] Child support - modified [3801] OFP obtained on behalf of children [3701]

Other: Other Value

Custody case results re: children (please check all that apply)

Physical custody - obtained [3101] Physical custody - preserved [3101] Right to parental access - obtained [3102] Right to parental access - preserved [3102] Child support - obtained [3801] Child support - preserved [3801] Child support - modified [3801] OFP obtained on behalf of children [3701]

Other: Other Value

Family Law - Mediation: result of representation

Full agreement [3905] Partial agreement [3904] No agreement [3903]

Other: Other Value

Immigration: result of representation (check all that apply)

obtained a benefit that avoided deportation [8101] obtained US citizenship [8104] obtained initial work authorization and now present in the USA under color of law [8105] obtained permanent residency [8106] obtained a benefit that promoted family unity [8107] obtained a benefit that is a pathway to permanent residency [8108] obtained a benefit that renewed or extended original status [8109] obtained a benefit to pursue removal defense [8110]

Other: Other Value

Real Estate: result of representation

Avoided foreclosure or other loss of home [6201] Completed title work [6202] Enforced homeowner's rights [6203] Settled dispute [6204]

Other: Other Value

Real estate results (please check all that apply)

Prevented foreclosure or other loss of home Obtained clean title to client's home Protected client's homeowner rights I believe client's housing will be stable for three months

Other: Other Value

Garnishment defense results (please check all that apply)

Recovered exempt income that had been garnished [259]? Prevented garnishment [258] Stopped a wage garnishment

Other: Other Value

If not adequately explained above, what was the legal result of your representation?

Court Case File Number (N/A if not applicable)

LETTERS TO CREDITORS CASES: please select

I am writing letters to this client's creditors on an ongoing basis and am completing this form for VLN’s administrative purposes only. If the client needs more letters to creditors in the near future, I will help. I will not be working on this case further

A funder is asking us to report whether anyone in the client's household was a veteran or a victim of domestic violence (including the client). This is information we would typically gather on intake, but for timing reasons need to ask temporarily when a case is closed. Please check below as appropriate

I do not know whether anyone in the client's household was a veteran or a victim of domestic violence. Someone in the household was a veteran Someone in the household was a victim of domestic violence

Documents

VLN funders require the representation agreement and (if applicable) the final order(s)/judgment(s) of your case. Please send them to us by one of the following:

- scan and upload them with this form

- scan and email them to your CPC or heidi@vlnmn.org

- fax them to Heidi at 612-238-2958

Representation agreement*

I have already sent I will send (fax, email or mail) I can upload them now I did not have client sign a representation agreement

Other: Other Value

Final order(s)/judgment(s)/settlement agreement(s)*

I have already sent I will send (fax, email, mail) I can upload them now

Other: Other Value

If you are not submitting the above documents now, please indicate the date by which you will be able to do this.

If you wish to upload documents, you may do so here.

No File Chosen

File uploads may not work on some mobile devices.

If you wish to upload documents, you may do so here.

No File Chosen

File uploads may not work on some mobile devices.

If you wish to upload documents, you may do so here.

No File Chosen

File uploads may not work on some mobile devices.

Client outcomes

Bankruptcy-specific outcomes - what kind of debt was discharged

medical debt regarding an uninsured car crash credit card debt debt which accumulated due to job loss debt which accumulated due to death of partner

Other: Other Value

Bankruptcy-specific outcomes (please check all that apply)

Enabled client to return to work without being garnished Enabled the client to reinstate his or her drivers license Stopped an active garnishment Resulted in the return of previously garnished funds Stopped ongoing harassing phone calls Stopped a pending debt collection lawsuit Prevented the shut off of client's utilities Prevented the interception of client's tax refund Prevented the repossession of client's car None of the above

Other: Other Value

Family-specific outcomes (please check all that apply)

protected relationship with children provided financial support for children

Other: Other Value

The below outcome questions relate to your client's life as a result of your services. Please select an outcome when it is likely to be true.

We greatly appreciate your time in doing this; it is required by our largest funder and also important in programmatic decisions and funding requests.

As a result of my legal services, it is likely that my client . . .

. . . is more able to pay for daily necessities*

Yes No N/A

. . . is less likely to be harassed by creditors*

Yes No N/A

. . . is now in a better position to keep or find a job*

Yes No N/A

. . . is now in a better position to keep or find housing*

Yes No N/A

. . . has improved housing conditions*

Yes No N/A

. . . is physically safer (including OFP or safety plan)*

Yes No N/A

. . . is more able to keep children safe*

Yes No N/A

. . . has improved quality of life*

Yes No N/A

Please comment on how client's quality of life is better - this is very helpful!

Other comments or benefits

Did your legal services prevent a bad outcome, or prevent a bad situation from getting worse?

Yes No

Other: Other Value

Please briefly summarize how.

Did your legal services protect money/benefits for the client?*

Yes No

"Protect" is defined as keeping resources/income/benefit the client was already receiving.

Some examples of cases in which money or benefits are protected include:

Preventing default judgments (the amount of money claimed in the complaint)
Bankruptcy discharges (the amount of the discharge)
Defending against garnishment actions (the amount of the garnishment and/or debt)
Preventing an order requiring the client to pay an amount (including in divorce cases)
Getting a child support modification appropriate to client income

Keeping child support at appropriate level when faced with reduction

If yes*

Bankruptcy discharge Federal money/benefit State money/benefit Child support Other money/benefit

Other: Other Value

If yes*

Lump sum/back payment ongoing monthly benefit

Other: Other Value

How much money was protected (please give dollar amount)?*

How much debt was discharged (please give dollar amount)?*

Are you including student loans listed on schedule F that were not actually discharged?*

Yes No

Please give the dollar amount of the student loans; if you don't know right now please indicate.*

Annual amount (please give dollar amount)*

Did your services recover money/benefits for the client?*

Yes No

"Recover" is defined as getting new resources/income/benefit.

Some examples of cases in which money or benefits are recovered include:

lifting inappropriate garnishment (bank accounts or wages)
established or increased child support or maintenance
return of security deposits
unemployment compensation benefits awarded

unpaid wage claims
rent abatement
debt forgiveness

If yes*

Federal money/benefit State money/benefit Child support Other money/benefit Garnished funds

Other: Other Value

If yes*

Lump sum/back payment ongoing monthly benefit

Other: Other Value

How much money was recovered (please give dollar amount)?*

Annual amount (please give dollar amount)*

How many people live in client's household?

Did you feel that you made a difference in your client's life? (Please check all that apply.)

Yes - more stability and/or well-being Yes - sense of being heard/respect Yes - reduced their stress Yes - gave clarity and useful information Yes - gave a sense of the process Yes - connected them with resources Yes - organized their paperwork No

Other: Other Value

Did you feel that you made a difference in your client's life? (Please check all that apply.)*

Yes - sense of being heard/respect Yes - reduced their stress Yes - gave clarity and useful information Yes - gave a sense of the process Yes - connected them with resources Yes - organized their paperwork Yes - more stability and/or well-being Maybe - but in any event, it makes a difference in MY life, professionally and/or personally No

Other: Other Value

What could have happened if your client had not had your help?

What were your client’s initial goals?

Were your client's initial goals met by your representation?

Yes. No, but the goals were not reasonable and my representation accomplished some goals. No, none of the client's goals were met.

Other: Other Value

Please explain.

How much do you think the client understood the proceedings?

Completely understood Somewhat understood Has no understanding

Other: Other Value

Was this compelling case that you think our funders and other volunteers should know about?*

Yes No

Please write a brief summary below about this case and why it is compelling. This could be an instance where volunteering was really meaningful to you, such as but not limited to, a great result for a client or connecting on a personal level with a client. All shared stories will be anonymous and/or with client approval. *

Is there anything else you want us to know about this case or your experience volunteering with VLN?

Please check all that apply

The form is fine. I did not find it burdensome. The form is somewhat burdensome, but I understand the need for the requested information The form was burdensome and I'd ask you to look for ways to make it shorter

Other: Other Value

Comments

Changes Log

7/3/16: changed fax number to the main fax number. And separated out from so this one collects data from the beginning of this fiscal year.

2/22/17: per Volunteer Committee, added section below about helping another client and added option for atty to be emailed info re: CLE credit for pro bono

3/18/17: per Volunteer Committee, changed section "What could have happened if your client had not had your help" to "Did you feel that you made a difference in your client's life? If yes, how?"

5/24/17: changed the withdrawal question distinguishing between client or attorney withdrewing; combined those into one option. And added option that the service was completed at a lesser level than full rep.

7/31/17: took out "VLN admin close" from the options of law firms. Staff looking for confirmation from a volunteer attorney for the work performed should complete the form Work Completed by Volunteer Attorney.

Are You Able to Help Another Client?

We currently have people waiting for help with the following types of legal issues. May we contact you about taking a full representation case (please check as applicable)?*

Yes - bankruptcy Yes - family law Yes - criminal expungement Yes - the same type of case I took before, but not right away. Please contact me later.

Other: Other Value