IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT ) ) ) ) ) ) ) ) ) Plaintiff, vs. Defendant. Case No. MOTION FOR APPOINTED ATTORNEY (for "Flores" appointments only) I request that an attorney be appointed to represent me for the following reasons: 1. Custody of my child(ren) is an issue in this case; and 2. The opposing party is represented by an attorney provided by the following public agency: Alaska Legal Services Corporation (ALSC) Alaska Network on Domestic Violence & Sexual Assault (ANDVSA) Other ; and 3. I cannot afford my own attorney. I filled out court form CR-206, Financial Statement, and attached it to this motion. Date Contact Telephone No. Signature Type or Print Name Certificate of Service I certify that on a copy of this Motion; a completed CR-206, Financial Statement; and a proposed Order (you may use court form TF-934, Order Appointing Counsel) was mailed hand delivered to: Opposing Party Opposing Attorney Other: Your signature: TF-933 (1/14)(cs) MOTION FOR APPOINTED ATTORNEY ("FLORES" only) American LegalNet, Inc. www.FormsWorkFlow.com 264 P.3d 835; 598 P.2d 893, Admin. Rule 12(c); AS 44.21.410(a)(4)