AMERICAN CIVIL LIBERTIES UNION OF KENTUCKY

A non-profit, non-partisan membership organization dedicated to preserving individual freedoms guaranteed in the Bill of Rights.

Legal Assistance Request Form

The ACLU of Kentucky offers legal assistance in certain cases involving civil liberties violations in which government is involved.  The ACLU of Kentucky does not handle disputes between private parties, including private employment disputes, domestic disputes, or child custody matters.  Due to limited resources, the ACLU of Kentucky cannot take all cases offered to us, even some concerning real injustices.

Instructions: Please print, complete, and mail this form to our office at:

ACLU of Kentucky
315 Guthrie Street  Suite 300
Louisville, KY  40202-3820

Complainant Information:

Name:

Address:

City, State, and ZIP:

Day Phone:

Night Phone:

Email Address:

My complaint is against the following:

Name:

Agency/Government Organization:

Address:

City, State, and ZIP:

Date of Act giving rise to this complaint:

Are you currently represented by an attorney (circle one)?    YES       NO

If YES, attorney's name:

Address:

City, State, and ZIP:

Phone:                                               

Has a criminal or civil lawsuit been filed against you or on your behalf (circle one)?    YES       NO

If YES, case title and case number:

Date filed:

Court:

Judge:

Opposing Attorney:

Current status of case: