APPLICATION FOR COURT APPOINTED LAWYER
In accordance with La. R.S. 15:175, before any person asserting indigency and requesting representation by a court appointed
lawyer may be considered for those services he or she must do the following:
1. Complete an application for those services.
2. Provide complete and accurate information about his or her financial status.
3. Pay a Non-Refundable Application Fee of $40.00, unless waived for good cause.
APPLICANT HEREBY AFFIRMS UNDER PENALTY OF PERJURY that he or she desires counsel but is financially unable to procure those services and
the following information concerning his or her financial means and obligations is true and correct to the best of his or her knowledge. Applicant
also agrees to report in writing any change in his or her address or financial status to Public Defender’s Office. Failure to remit payment
will result in your Tax refund being deducted by the amount in which you owe this office plus any required processing fees.