Application For Appointed Defense Services
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Application For Appointed Defense Services Form. This is a Kansas form and can be use in 3rd Judicial District (Shawnee County) Local District Court.
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Tags: Application For Appointed Defense Services, Kansas Local District Court, 3rd Judicial District (Shawnee County)
F 3.405(I)
IN THE DISTRICT COURT OF SHAWNEE COUNTY, KANSAS
______________________________
**CAPTION**
vs.
______________________________
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Case No. [Case Number]
Document No. _____________
APPLICATION FOR APPOINTED DEFENSE SERVICES
(To accompany Financial Affidavit)
NOTICE TO APPLICANT:
A. General Information
1.
The information on the attached affidavit is not confidential.
2.
False entries may lead to criminal prosecution and conviction.
3.
If you do not understand a specific question or need help, ask for assistance.
4.
The judge or hearing officer may place you under oath and inquire further about any
information provided on this form.
B. Eligibility for Defense Services
1.
Appointed counsel and other defense services will only be provided to people who
cannot afford to pay for these services themselves.
2.
If, after the date of the alleged offense, you transfer any of your property for less than it
is worth, the State may sue to obtain repayment of the cost of your defense.
3.
You must inform the court if there is a change in any of the financial information given
on the Affidavit.
Affidavit
I have read or have had read to me and understand the above notice and the attached Financial Affidavit.
I further state that I am of lawful age and that under penalty of perjury I declare that the information I
have provided on the Financial Affidavit is true, and I hearby request that court-appointed counsel be
provided to me.
____________________
Date
_______________________________________________
Signature of Applicant
Subscribed and sworn to before me this _______ day of __________________________, 20___.
My commission expires _____________________
________________________________
Notary Public / Deputy Clerk
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