Certification Of Continued Indigency And Eligbility For Appointment Of Counsel On Appeal

STATE OF NEW YORK COUNTY OF IN THE MATTER OF FAMILY COURT Certification of continued indigency and eligibility for appointment of counsel on appeal. Petitioner, -againstFamily Court Docket No. Respondent. I an attorney-at-law, certifies as follows: County ( I 1. That this is an appeal from an order of the Family Court, entered I J.), which 2. That a notice of appeal was timely filed in the timely served on all necessary parties. County Family Court Clerk's Office and 3. Appellant or movant has been represented in Family Court by assigned counsel or a law guardian pursuant to sections 249, 262 or 1120 of the Family Court Act, or section 722 of the County Law, or by a legal aid society or legal services program or other nonprofit organization which has as its primary purpose the furnishing of legal services to indigent persons, or by private counsel working on behalf of or under the auspices of such society or organization. 4. That appellant or movant has indicated an intention to appeal. 5. That appellant or movant continues to be indigent and to be eligible for assignment of counsel. 6. A copy of this certification is being provided to the County Attorney. Please check the applicable sentence below: I will continue to serve as counsel on the appeal. I request appointment of other counsel on the appeal. DATED: Signature Print Name: Address: *Send the original of this certification along with a copy of your notice of appeal and the order being appealed to the Clerk's Office, New York State Supreme Court, Appellate Division, Third Department, PO Box 7288, Capitol Station, Albany, NY 12224-0288. Also send a copy of this certification to the County Attorney. American LegalNet, Inc. www.USCourtForms.com