CASL Legal Services Application

Instructions

Please complete this form to request a phone consultation with the CASL Legal Services Program.

This form includes two sections:

  • Section 1: Collection of your basic information, preferred language, and the type of legal issue you are seeking assistance with.

  • Section 2: Collection of household income information, which is required to determine eligibility for free legal services.

Important Notice:
Eligibility for legal services is determined based on household income, residency, and case type. Submission of this form does not guarantee that services will be provided. CASL reserves the right to deny services if eligibility requirements are not met or if a conflict of interest exists.


请填写本表，以申请与 CASL 法律服务项目进行电话咨询。

本表共分为两个部分：

  • 第一部分： 收集您的基本信息、首选语言，以及您希望咨询的法律事务类型；

  • 第二部分： 收集您的家庭收入信息，用于评估您是否符合免费法律服务的资格。

重要说明：
法律服务资格将根据家庭收入、居住情况及案件类型综合评估。提交本表并不代表一定可以获得法律服务。如不符合资格要求，或存在任何利益冲突，CASL 有权拒绝提供法律服务。








CASL Legal Services are available to Illinois residents only. 申请人必须为伊利诺伊州居民方可获得本法律服务。





Household Income Disclosure Statement 家庭收入信息声明

Why We Ask About Household Income and Household Size


To determine whether you are eligible for pro bono (free) legal consultation, we are required to collect information about your household income and household size, including the number of adults and minors in your household.

We understand that this information is personal and sensitive. Please know that your responses will be kept confidential and used solely to assess eligibility for our pro bono legal services, in accordance with program requirements and applicable privacy policies.

Providing accurate information helps us ensure that our limited legal resources are directed to individuals and families who qualify for and most need these services.

我们为何需要询问家庭收入与家庭成员人数

为确认您是否符合公益（免费）法律咨询服务的资格，我们需要收集您的家庭收入情况以及家庭成员人数，包括家庭中的成年人及未成年人数量。


我们理解这些信息具有一定的个人敏感性。请您放心，您所提供的所有信息将被严格保密，并仅用于评估您是否符合公益法律服务的资格，相关使用将遵循项目要求及适用的隐私保护政策。


您所提供的准确信息，将有助于我们将有限的法律资源合理分配给最符合条件、且最需要帮助的个人与家庭。

Household Information 家庭信息



Number only, 仅填写数字

Number only, 仅填写数字

Number only, 仅填写数字

Number only, 仅填写数字

Please provide brief detail of your other income, 请对其它收入做出简要说明

Number only, 仅填写数字

Monthly special expenses are ongoing and unavoidable costs that place a financial burden on your household, such as medical expenses, disability or special care, childcare or dependent care, court-ordered payments, or transportation for medical or work-related reasons. “每月特殊支出”是指每月持续发生、无法避免、并对家庭经济造成负担的费用，例如医疗费用、残障或特殊照护支出、子女或受抚养人照护费用、法院判决的相关支出，或因医疗或工作需要产生的交通费用。

Please provide brief detail of your special expenses, 请简要说明特别支出


If you currently have no income, please explain your situation in detail below. 若您现在无任何收入，请在此做详细说明
Confirmation 确认