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John Agner  
John M Agner, Attorney At Law  
214 S William St.  
Goldsboro, NC 27530  

jagner1@bellsouth.net  




Please complete the following form and click Submit. We will contact you as soon as possible regarding your request.

First Name *
 Middle Name
 Last Name *
Street Address
City
 State
 		Zip Code
E-mail Address *
Contact Phone
 Evening Phone
What are the charges listed on your ticket? Please be exact when listing them
What is your date of birth?
What is your drivers license number, what state?
What address would you like your mail sent to?
What is your daytime phone number?
What is your next court date?
What is the offense date of your ticket, what day did you get the ticket on?
Have you missed a court date for this ticket?
Have you had this case continued already, how many times?
Who is your liability insurance provider, what is your agents name and phone number?
Have you had an accident that your insurance company has had to pay for in the past three years?
Have you ever had a conviction for DWI "Driving While Impaired"?
Questions / Comments
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