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ST'A'I'E O1~ FL(~It I UA ~S'7s93
vs CAS~ NO(S). ~73_A01-MM-~-O1
CHARGE(S} (`nntrih ~rin~ T~ The Delinqu~
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DeFendant
STATEMF.NT AND AFFInAVIT OF INSOLVENCY UNDER OATH
1. I have been placed under oath and make this statement anc
affidavit under this oath.
2. I want and request~the Public Defender to be my lawyer and
represent me in this case.
3. I have been advised and I understand that the Public Defender
cannot be my lawyer or represent me if I have ~he money or
property to hire a lawyer. '
4. I am making this statement and affidavit for the purpose of
- causing the Public Defender to be my Iawyer and represent
me in this case.
5. I have no property such as land, houses or buildings, auto-
mobile, stocks or bonds or other things of value or money
either in my possession or that I can use or cause to be used
to obtain or get the money to hire a lawyer to represent me
in this case.
6. I~understand that the services of the Public Defender, if
he represents me in this case, are not free, that I wili hav~
to pay a reasonable fee, determined by the Court, for these
services, or I will be obligated to pay such fees and that a
claim or liea wi1Z be placed against any property that I may
have now or in the future. I waive any further notice of
hearing when the Court sets this £ee or of the filing of the
. lien.
.~~~~~7... I have no way to get a lawyer and unless the Public Defender
..~;~=~`~,..G ~"`':~~represents me, my rights under the law in this case will
~ . •~'~~not be protected.
. JG`,y ` _ , J
. . ~a Y"~_ 1• ' eO \ ~7 ~ /
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- . . Defendant's igna~tire
~ . .
~ "Si~BSC~IBED AND SWORN TO before me this
~ ~ ~ of ria ~ , A. D. ,19 73 ~ FILEO AND RECORDED~
~ ~ LUCIE COUNTY, FLA.
` ^f1~:^ :'~R~c~ED
~ County- Judge '~y ~ ~
~ ORDER '73 ~~~Y Z 4 PM I? :
;
€
` Based on the above affidavit, it is ~'~~T~~~•-=
~ CLERK CIRCUIT COURT
~
s ORDERED, ADJUDGED AND DECREED that the Defendant be, and
he is hereby declared to be insolvent within the meaning of
~ Sec: 924.1~ Florida Statutes; and it is further
~
~
; ORDERED, ADJUDGED AND DECREED that the office of the '
Public Defender is hereby appointed to represent the above
named defend~-?.nt.
= DONE AND ORDERED at Fort Pierce, Saint Lucie County,
Florida, this ~~day of_ ~taT ,A.D.,19_~_.
' ..+,"~'•~:n~~r fI:ED ay~ 'Q_C~RDED
} ~+('jl~~C ST.LUC;E ~J.~N'Y FLA•
~ • ; R~,,: , TA~ES
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~ " , County J ge ~
' -~T ~uN Z~ 3 0~ PM'73
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_ _ _ • . . : 25
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