Motion For Appointment Of Attorney

FIRST JUDICIAL DISTRICT COURT STATE OF NEW MEXICO COUNTY OF ____________________ _______________________________ Petitioner, v. _______________________________ Respondent. No.__________________________ MOTION FOR APPOINTMENT OF ATTORNEY COMES NOW _____________________________________, and moves this Court for an order allowing the appointment of an attorney. As grounds for this motion, movant states that because of indigency, I cannot afford to pay for an attorney to represent me. I have attached the affidavits required by the Administrative Order No. 2004-4. __________________________________________ Signature of Applicant FIRST JUDICIAL DISTRICT COURT American LegalNet, Inc. www.FormsWorkFlow.com STATE OF NEW MEXICO COUNTY OF ____________________ _______________________________ Petitioner, v. _______________________________ Respondent. No.__________________________ AFFIDAVIT OF INDIGENCY STATE OF NEW MEXICO ) ) ss. COUNTY OF __________________) I, ______________________________, make under oath the following statements regarding my financial, marital and employment status, and since I am unable to pay for an attorney to represent me in the above-captioned case, make application to proceed in accordance with Administrative Order No. 2004-4. BACKGROUND AND RESIDENCE 1. 3. Full name: ________________________________________ 2. Age:______ Present address: ____________________________________________________ ____________________________________________________ 4. 6. How many years at this address? _______ 5. Telephone No. ________________ Marital Status: Married [ ] Single [ ] Divorced [ ] Separated [ ] Children Adult American LegalNet, Inc. www.FormsWorkFlow.com 7. 8. 9. Number of dependents (including yourself): _________ _________ Ages of minor children living with you: _________________________________ List name and relationship of adult dependents whom you support: Name: Relationship: EMPLOYMENT AND INCOME: 1 2. Employed [ ] Not Employed [ ] Self-employed [ ] Name and address of employer: _________________________________________________________________ _________________________________________________________________ 3. 4. 5. Position: _________________________________________________________ Gross salary per month: $_______________ If self-employed, nature of business: ___________________________________ _________________________________________________________________ _________________________________________________________________ OTHER INCOME: American LegalNet, Inc. www.FormsWorkFlow.com In addition to wages and salary, I receive the following income: A. B. C. D. E. F. G. H. I. Social Security / Disability Welfare Unemployment Food Stamps AFDC VA Child Support Alimony Investments Total: ASSETS 1. Do you own any real estate? A. B. C. D. E. Yes [ ] No [ ] $______________________ $______________________ $______________________ $______________________ $______________________ $______________________ $______________________ $______________________ $______________________ $______________________ Description:_________________________________________________ Location:___________________________________________________ Estimated present value $_______________ Estimated outstanding mortgages or contracts on property:$___________ Payments per month:$__________________ 2. Do you own any automobiles? Yes [ ] No [ ] American LegalNet, Inc. www.FormsWorkFlow.com A. Make/Model_______________ _______________ Year ________ ________ B. Present Value $_____________ Total Amount Owed $_____________ $_____________ $_____________ C. Monthly payments $_________ $_________ 3. Do you have any stocks or bonds? A. B. Yes [ ] No [ ] Description_________________________________________________ Present Value $_______________ Yes [ ] No [ ] 4. Do you have cash in the bank? A. If so, indicate amount $_________ 5. Do you have any other assets not listed above excluding household furnishings and clothing? A. Yes [ ] No [ ] If so, describe and give value __________________________________ ____________________________________Value: $_______________ DEBTS AND OTHER OBLIGATIONS: 1. The following are my current obligations: A. B. C. D. E. F. House payment / rent per month Utilities per month Telephone per month Groceries Gasoline Insurance $ $ $ $ $ $ American LegalNet, Inc. www.FormsWorkFlow.com G. H. I. J. Medical Bills Child Care Other Other $ $ $ $ Total: $ _________________________________ SIGNATURE OF APPLICANT SUBSCRIBED AND SWORN TO before me by _______________________________ this _______________ day of _________________________, ________________. _________________________________________ My Commission Expires: _____________________ NOTARY PUBLIC FIRST JUDICIAL DISTRICT COURT STATE OF NEW MEXICO COUNTY OF ____________________ American LegalNet, Inc. www.FormsWorkFlow.com _______________________________ Petitioner, v. _______________________________ Respondent. No.__________________________ ORDER FOR APPOINTMENT OF ATTORNEY THIS MATTER having come before the Court on ____________________________=s motion for appointment of an attorney, and showing of indigency by affidavit(s), and the Court being otherwise advised in the premises, the Court orders that the movant: 1. ______ have the following attorney appointed: _____________________________. 2. ______ be denied the appointment of an attorney. _________________________________________ DISTRICT COURT JUDGE American LegalNet, Inc. www.FormsWorkFlow.com