To request an Appointed Attorney you must complete this entire form. All information must be provided by the defendant and must be current, accurate and true. Be advised, intentionally or knowingly giving false information may result in your prosecution for the offense of perjury.
Based upon the Federal Poverty Guidelines, as determined by the Department of Health and Human Services (DHHS), if the Court determines that you can afford an attorney, the Court is entitled to deny your request for an Appointed Attorney, or you may be ordered to pay the Court back a portion of the attorney fees as determined by the DHHS guidelines. Any payment you may be required to make under the guidelines shall only be ordered if you are convicted and/or take a plea to an offense.