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8.932 Application for Counsel and Order
APPLICATION FOR COUNSEL
AND ORDER
STATE OF FLORIDA
COUNTY OF ....................
Before me, the undersigned authority, personally appeared
affiant, who, being duly sworn, says:
1. That I understand a delinquency complaint has
been made against me and, being advised of my right
to an attorney, now request appointment of counsel.
2. Being without sufficient funds, property or assets
of any kind, I will be deprived of my right to representation
unless I am adjudged insolvent and counsel
appointed to represent me.
3. That I have been informed that a lien for the value
of the legal services rendered to me by the public
defender may be imposed by law on any property I
now or may hereafter have in this state.
Dated: ....................
__________________
Affiant Child
STATEMENT OF PARENT(S)
The undersigned are informed and understand that
liability for cost of representation of this child by the
public defender can be assessed against the parent(s)
by court order in an amount not to exceed the amount
provided by law.
________________
Parent
________________
Parent
ORDER
The court finds that this child is indigent, as defined
by law, and is desirous of counsel; it is, therefore,
ORDERED
1. That this child is declared to be insolvent.
2. That ...................., Public Defender for the ..... Judicial
Circuit, State of Florida, is hereby appointed as
counsel to represent this child in all matters in defense
of the delinquency complaint herein made.
DONE AND ORDERED in the circuit court in and
for .................... County, Florida, on .....(date)......
__________________
Circuit Judge
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