Affadavit Of Indigency Parent Attorney Form

ADVERTISEMENT

COURT DATE________________________
ATTORNEY APPOINTED________________________
IN THE JUVENILE COURT FOR ANDERSON COUNTY, TENNESSEE
PARENT ATTORNEY
Type of Case: _____ Dependency/Neglect – Parental Counsel
_____ Delinquent/Unruly
_____ Child Support /Contempt
_______
IN RE:____________________________________________DOB________ J-_______________ /_____-______________
_______
IN RE:____________________________________________DOB________ J-_______________ /_____-______________
_______
IN RE:____________________________________________DOB________ J-_______________ /_____-______________
_______
IN RE:____________________________________________DOB________ J-________________/_____-______________
Plaintiff __________________________________________________v Defendant____________________________________________
UNIFORM AFFIDAVIT OF INDIGENCY
PART I
1. Full Name: _______________________________________________________ 2. Soc. Sec. No.:________________________________
3. Any other names ever used: _______________________________________________________________________________________
4. Address:_____________________________________________________________City/State___________________________________
5. Telephone Nos.: (Home) _____________________________ (Work) __________________________(Other)_______________________
6. Are you working anywhere? ( ) yes ( ) no Where? ____________________________________________________________________
Employers Name and Address: _______________________________________________________________________________________
7. What is your income? $ ___________________________ ( ) weekly ( ) monthly ( ) other ________________________________
8. Date of Birth ____________ Month _______________ Day _____________ Year
9. Do you receive any governmental assistance or pensions (disability, SSI, AFDC, SSD, Social Security, (etc.)? Yes ( ) No ( )
What is the value? $________________________________ ( ) weekly ( ) monthly ( ) other ________________________________
10. Do you own any property (house, vehicles, bank accounts, land, cash, jewelry, guns, etc.)? Yes ( ) No ( )
What is the total value? $_________________________________________________________________________________
11. Are you, or your family, going to hire a private attorney? Yes ( ) No ( )
12. Are you, or your family, going to be able to post bond? Yes ( ) No ( )
13. Are you now in custody? Yes ( ) No ( ) If so, how long? ____________________________________________________
(If the defendant is in custody, unable to make bond and the answers to questions one (1) through eleven (11) make it clear that the defendant has no resources to hire a private
attorney, skip Part II and complete Part III. If Part II is to be completed, do not list items already listed in Part I.
PART II
14. Names and ages of all household members and dependents:
____________________________________________ relationship _______________________________________________
____________________________________________ relationship _______________________________________________
____________________________________________ relationship _______________________________________________
15. I have met with following lawyer(s), have attempted to hire said lawyer(s) to represent me, and have been unable to do so:
Name: _________________________________
Name: _________________________________________
Address: _______________________________
Address: _______________________________________
_______________________________________
_______________________________________________

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Notice Of Change Of Address For Attorney Form - United States Bankruptcy Court For The District Of Colorado Notice Of Change Of Address For Attorney Form - United States Bankruptcy Court For The District Of Colorado Legal
Form Rv-f1301201 - Affadavit Of Non-dealer Transfers Of Motor Vehicles And Boats Form Rv-f1301201 - Affadavit Of Non-dealer Transfers Of Motor Vehicles And Boats Financial
Form Cv-410a - Petition For Waiver Of Fees And Costs - Affidavit Of Indigency Form Cv-410a - Petition For Waiver Of Fees And Costs - Affidavit Of Indigency Legal
Form Cv-410a - Petition For Waiver Of Fees And Costs - Affidavit Of Indigency Form Cv-410a - Petition For Waiver Of Fees And Costs - Affidavit Of Indigency Legal
Form Opd-206r - Financial Disclosure / Affidavit Of Indigency Form Opd-206r - Financial Disclosure / Affidavit Of Indigency Legal
Form 73-334 - Request For County Reimbursement Of Indigent Inmate Representation Form 73-334 - Request For County Reimbursement Of Indigent Inmate Representation Financial
Form Ad 927 - Statement Of Understanding - Parent Who Places The Indian Child With The Prospective Adoptive Parent(s) Form Ad 927 - Statement Of Understanding - Parent Who Places The Indian Child With The Prospective Adoptive Parent(s) Legal
Form Ad 926 - Statement Of Understanding - Parent Who Places The Child With The Prospective Adoptive Parent(s) Form Ad 926 - Statement Of Understanding - Parent Who Places The Child With The Prospective Adoptive Parent(s) Legal
Indigent Fee Waiver Form - Georgia Indigent Fee Waiver Form - Georgia Legal
Parental Consent Forms For Minor Children Traveling Without Both Birth Parents Parental Consent Forms For Minor Children Traveling Without Both Birth Parents Legal

Related Categories

Parent category: Legal
Download
Go
Page of 4