© 2026 Worldtec / CivicFlow · All rights reserved
CivicFlow
POPIA · ECTA Compliant
Confidential Legal Intake · South Africa

Wrongful Arrest
Intake Form

Secure · Encrypted · Legally Admissible

1
Identity
2
Arrest
3
Facts
4
Docs
5
Declare
⚠️ This application is the intellectual property of Worldtec. Unauthorised copying is prohibited.
👤
Personal Details
Protected under POPIA.
Next of Kin
Step 1 of 5
🛡️
Arrest Details
Specifics about the incident.
Public Order / Police
Trespassing
Failure to comply
Breach of the peace
Resisting arrest
Failure to produce ID
Interfering with officer
Traffic / Transport
Reckless driving
DUI
No licence
Outstanding fines
Property
Theft
Robbery
Housebreaking
Suspected stolen property
Malicious damage
Fraud
Person / Violence
Assault (common)
Assault GBH
Intimidation
Pointing a firearm
Drugs / Weapons
Drug possession
Drug dealing
Unlicensed firearm
Dangerous weapon
Other
Outstanding warrant
Contempt of court
Mistaken identity
None stated / No charge
Other
CAS Number
Docket Number
Case Number
Arrest Ref
📝
Facts of the Case
Describe what happened.
Minimum 100 words recommended.
Employment & Loss of Earnings
📎
Supporting Documents
Tick and upload what you have.
📄 ID — Front
📄 ID — Back
🧾 Bail Receipt
🏥 Medical Report
📷 Photo Evidence
⚖️ Court Documents
📁 Other
✅
Declarations & Signature
Confirm and sign.
I declare that all information is true and accurate.
I consent to processing of my personal information under POPIA.
I understand this does not create an attorney-client relationship.
Limited Authority: I authorise CivicFlow to share this intake with an assigned attorney for assessment only.
⚖️
ECTA Notice
Your digital signature is legally valid under the Electronic Communications and Transactions Act No. 25 of 2002.
Sign with finger or mouse
✅
Intake Submitted Successfully

Your reference number:

Your intake has been securely received and recorded.
A confirmation email has been sent to .
CivicFlow will contact you within 2 business days.