26 Judicial District
SelfServe Center

You must completely read the following disclosure and agree to the acknowledgements that follow the disclosure in order to gain access to SelfServe Center forms.

Disclosure

The SelfServe Center cannot act as your lawyer or provide legal advice!
The forms, services, and materials provided in the SelfServe Center are for your use in the legal representation of yourself. The personnel in the SelfServe Center cannot tell you what your legal rights or remedies are, represent you in court, prepare your documents, or tell you what to say on the forms or in court.

If you have a question about your case, please consult with an attorney!
If you have any questions about the information provided, how to proceed with your case or your legal rights, you are strongly urged to seek the advice of an attorney. If you do not know an attorney, you should contact the Mecklenburg County Bar Lawyer Referral Service at (704) 375-0120 for the North Carolina lawyer referral service at 1-800-662-7660. If you cannot afford an attorney you may be eligible for representation from Legal Services of Southern Piedmont at (704) 376-1600 in certain cases.

What you tell us is not confidential!
Nothing you say, write, or receive from the SelfServe Center staff is confidential. Please DO NOT discuss the specifics of your case as it may be subject to disclosure at a later time. The staff cannot guarantee who may overhear your discussions. Note: this center is a public service to all members of the community. Your opposing party may also use this center.  

Acknowledgement

By typing your name below, you acknowledge the following
  • I understand that the SelfServe Center and its staff cannot represent me in court or give me legal advice or assistance.
  • I understand I am not entitled to any guarantees of confidentiality while using the SelfServe Center.
  • I am over the age of 18 years.
  • I am able to read English and/or requested explanation of any parts of the form I did not understand
  • I fully understand the contents of this form.
  • I agree to these conditions knowingly, willingly and voluntarily. 
If I cannot read, this form has been read and explained to me by:

Please provide the following Information for our records.   * Fields are required.

1.
*  First Name:
Middle Initial:
*  Last Name:
2.
*  Zip Code:
3.
*Date (MM/DD/YYYY)
4.
*  Have you ever visited the SelfServe Center in person?
Yes
No
5.
* Reason for accessing this site
If Other, please specify:
6.
*  How did you learn about this website?

The following information is for our statistical records.  Your answers are voluntary, but your cooperation is designed to help our program and is appreciated.

7.
Age:
18 - 25
26 - 35
36 - 45
46 - 55
56 or over
8.
Sex:
Female
Male
9.
Language:
English
Spanish
French
Other
10.
Education:
8th grade or less
Some highschool
Completed highschool
Some college
College grad
Advanced degree
11.
Ethnic Background:
Caucasian
African American
Native American/Eskimo
Hispanic/Latino
Asian
Other
12.
Income Level:
$0 - $9,000
$9,001 - $25,000
$25,001 - $40,000
$40,001 - $50,000
Over $50,000
13.
Please explain why you decided to represent yourself:
14.
Suggestions for improvements or comments: