270 North Broad Street

Brooksville, Florida 34601

Thank you for your interest in Benda Law!

Before we can schedule your consultation, you must fill out this form. Once you complete this form, our office will contact you within 24 hours to schedule your complementary consultation.

Contact information

Prefix

First name *

Middle name

Last name *

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

What is the reason that you need legal representation?

If you are seeking representation for litigation or a Family Law matter, what is the name of the opposing party? If you are not seeking representation for litigation or a family law matter, please type "N/A" and go on to the next question.

If you are seeking representation for Real Estate or Land Use matters, in what county or municipality is the property located and what is the property owner's name? If you are not seeking representation for real estate or land use matter, please type "N/A" and go on to the next question.

If you are seeking representation for preparation of a Contract or other legal document, what is the name of the people or entities that will be the parties to the contract or other legal document? If you are not seeking preparation of a contract or other legal document, please type "N/A" and go on to the next question.

If you are not seeking representation for family law, real estate, or legal document preparation, what are the name(s) of the parties, people, or entities that are relevant to your legal issue?