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Application For Crimingal Indigent Status (PDF) - 202011131550396606
Application For Crimingal Indigent Status (PDF) - 202011131550396606
CLERK DETERMINATION
______ Based on the information in this Application, I have determined the applicant to be (__) Indigent (__) Not Indigent
______ The Public Defender is hereby appointed to the case listed above until relieved by the Court.
Dated this ___day of __________________, 20______ _____________________________________________________
Clerk of the Circuit Court, by Deputy Clerk
This form was completed with the assistance of: _____________________________________________________
Clerk/Deputy Clerk/Other authorized person
APPLICANTS FOUND NOT INDIGENT MAY SEEK REVIEW BY ASKING FOR A HEARING TIME. Sign here if you want the judge to review the clerk’s
decision of not indigent. ________________________________________