State of Alabama Unified Judicial System Form C-11 Rev. 2/06 REQUEST/APPOINTMENT/ACCEPTANCE OF ATTORNEY/GUARDIAN AD LITEM Case Number Part I IN THE_______________________________________COURT OF ________________________________________, ALABAMA (Name of County) (Circuit or District) ____________________________________________________v. __________________________________________________ (Plaintiff) (Defendant) Civil Case In the Matter of:___________________________________________________________, a child (Juvenile Case) State of Alabama v. ________________________________________, Defendant (Criminal Case) request that (check one of the following boxes): an Attorney a Guardian ad Litem be appointed for: ________________________________________________________________________________________________________________, (Name of person to be represented) _____________________ Date ____________________________________________ Signature of Requestor Part II After evidence has been presented to the court that the above-named person to be represented is indigent and is entitled to appointed counsel, the court appoints ____________________________________________________________________________________________ as (Name of Attorney or Guardian ad Litem) Attorney Guardian Ad Litem _____________________ Date ____________________________________________ Signature of Judge Part III I accept the above appointment as: Attorney Guardian ad Litem _____________________ Date ____________________________________________ Signature of Attorney or Guardian ad Litem American LegalNet, Inc. www.FormsWorkflow.com