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  • Early Man Accused of Sexual Abuse 3rd Degree, Going Armed With Indent, Domestic Abuse Assault, and Assault While Participating in A Felony

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    thesacnews
    201 просмотров6 страниц
    In support of my application for appointment of counsel, and under penalty of perjury, the undersigned states: Name: jfca -.- U n n m Home Phone: 7)p Street Address: / / W o -t-va Birth Date: n W I W o-t-va Birthdate: I I I iii. I understand I may be

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    Early Man Accused of Sexual Abuse 3rd Degree, Going Armed With Indent, Domestic Abuse Assault, And Assault While Participating in a Felony

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    In support of my application for appointment of counsel, and under penalty of perjury, the undersigned states: Name: jfca -.- U n n m Home Phone: 7)p Street Address: / / W o -t-va Birth Date: n W I W o-t-va Birthdate: I I I iii. I understand I may be

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    Скачайте в формате PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    201 просмотров6 страниц

    Early Man Accused of Sexual Abuse 3rd Degree, Going Armed With Indent, Domestic Abuse Assault, and Assault While Participating in A Felony

    Загружено:

    thesacnews
    In support of my application for appointment of counsel, and under penalty of perjury, the undersigned states: Name: jfca -.- U n n m Home Phone: 7)p Street Address: / / W o -t-va Birth Date: n W I W o-t-va Birthdate: I I I iii. I understand I may be

    Авторское право:

    Attribution Non-Commercial (BY-NC)
    Скачайте в формате PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 6

    E-FILED 2014 MAR 12 4:21 PM SAC - CLERK OF DISTRICT COURT

    E-FILED 2014 MAR 12 4:21 PM SAC - CLERK OF DISTRICT COURT

    E-FILED 2014 MAR 12 4:21 PM SAC - CLERK OF DISTRICT COURT

    E-FILED 2014 MAR 12 4:21 PM SAC - CLERK OF DISTRICT COURT

    8-0\
    IN THE IOWA DISTRICT COURT FOR_ STATE OF IOWA or Plaintiff/Petitioner,
    vs.

    Sac Criminal

    COUNTY CivU

    FINANCIAL AFFIDAVIT/APPLICATION FOR APPOINTMENT OF COUNSEL Defendant/Respondent.

    In support of my application for appointment of counsel, and under penalty of perjury, the undersigned states: Name: jfca -.-^ U n n m Home Phone: ~7)p Street Address: /// V e \n W i \ W o -t-VA Birth Date: E-mail: ( V 3- ~g1

    )- l~i-TD^C~e\\ Phone: fro** <A<*r)r Street/P.O. Box


    v

    'Af&#

    c^"^y
    fs<awAt.,\

    State

    Zip

    Pending charges: <An(\i^ Do you have a job? ^ Who do you work for?

    C A C Y ^ . y ^ A r ^ p -^P^inkase , Yes, Full Time

    In Jail? ^ Yes No )

    No Job

    Y e s , Part Time (List Hours/week:

    How much money do you currently make before taxes or deductions?

    per hour month year cO

    How much money have you made in the last 12 monthsfromany source, before taxes or deductions? How many family members are supported by or live with you? If a spouse lives with you, how much money does your spouse make? A c > & ~ > List all other money you, or anyone else living in your household, has coming in:

    per hour month year

    List what you own including money in banks, cars, trucks, other vehicles, land, houses, buildings, cash, or anything else worth more than $100:

    ist amounts you pay monthly for mortg es, rentj car loans, credit cards, child support, or any other debts:

    I understand I may be required to repay the State for all or part of my attorney fees and costs, I may be required to sign a wage assignment, and I must report any changes in the information submitted on this financial affidavit. I promise under penalty of perjury that the statements I make in this application are true and that I am unable to pay for an attorney to represent me.

    Date 3-ta-l

    e
    Rev. I/6/I2

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