On January 11, 2022 a
Request,Application
was filed
involving a dispute between
and
Chaney, Treviiyonst,
in the District Court of St. Lucie County.
Preview
a -IN THE CIRCUIT/COUNTY COURT OF THE NINETEENTH JUDICIAL;
IN AND FOR ST. LUCIE COUNTY, FLORIDA
CIRCUIT —
,
STATE OFFLORIDA, } . cons, 20220 Vd €
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LF ,
YwflenAL. thr
DEFENS BNOR CHIL 7 | . .
; i ICAT ON
FOR CRIMINAL INDIGENT STATUS =~ : os
_.._(_\ AM SEEKING THE APPOINTMENT OF THE PUBLICDEFENDER 7 -
.____JHAVE A PRIVATE
OF INDIGENT
ATTORNEY
STATUS FOR
OR AM
COSTS.
SELF-REPRESENTEDeAND SEEK DETERMINATION :
. ;
; ttetoshpcant:
spptcaiion padThe topro
fe Is riot the Clackofwlihinube7 days,
defender apptto costsiverand
wil be addsd thatmaycoatprocesagsine!sevice
be asentcod ynrat tscttoaTbarei
cancisiono $50 feA judgment
foreachandwpcetfon
this case. fon vrnay beedimposed
ff
ecohet eal dlot personal properly you own fo pay for legal and ofher services provided on your behalf or cr-behall of hexparzon for who you
making fis application. fyou area
,parentioge guardian making fis application on behalfofa minor or dependent edu, he
formation contaloed i
s-apglaston must
nce yourncome and
Sets,
L.Uhewe,___dependerits. (Do not include chidran not fving at home and-cowahden tntemanmmiggpimmarse or yoursell,)
. |. theea
(Take hometakehomeequals
income Incomesalery,of $200
0720.
wages, bonuses,GUpaid() veckty
commissions, (mamma
allowances,
ave eye srDeity(set
enis, arequired by
minus deductions
. 3. tha-ve other Income
paid ( )
weekly () every two weeks ( ) semi-monthly ( ) monthly
) yearly.,fiaais"Wea” and ff In the amountif you have
this kindof income, otherwise
circle ‘No') .
_"Social SecurityDen
Vetorarria!
Unengiloyment «nnsesannasensnme n seLCOS
DOMGPTEcompensation
operoescon..........-
s Yes <8
$ ©
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Reemtal nn menor naaa
(CONTIG
Ret eMertpenTONs emrenernvn rinneneennee
s ecev ececsere re VOSS
VOS $s
mnnmmanneioneervsccenncese VOR $
: Je : : .
Child suppert
or offerregularsuppor: Dividencis ar in"sree
nana veeneeeernees VES5
from tanlly mrembera/apeune ........ Yt 5 TRUBS HED...eceevennreemaserenmeneraenerecsseesesanneers VOR $
:
Dietary FETS
cececeeeeseeeuenteeencseeneeene
YOS $e € Other kinds of income not on the fst........... Yes$
7
4, Ihave otherassets:(Circle.“Yos"
and filin the
value
of the property, otverwise circle “Ko;
use the
backto orovieadditional information)
:
‘res Bank
Lo
account(s)e
SAVANE
c
ec
sse
c
nn
en
seo
nr
ev
es
cs
ese
sse
sc
neVOB§
(TS ;
f :
ecco snes cosmnsonsnsninesvaneccenennersnesecere VS
:
“Equityin
real
estate
(exciudinghomestead)...Yes
List the alidrass of thisproperty
So [ee
$
[ad
$a
.
“Equity in motor vehicies/DOatel .—vcnesecnecceeeYO8
SS
eo SDC IDI of
Corfficates rn
deposit
or ; VOSS : : "Equity;
meansvelue minus loans.
Al: ast jan —
interest
. MONEY?MEFKA?ACCOUNTS eens Yess___fia) in such property. us 80, ist eny expectancy
in an |
5.| heavetotal
Hlabilities
and dabts intheamount ofSOCAL 2. SECON | 3 Incomplete :
Oe | fl rweeive:Assistance
Jemnporry (Circle “Yes”for orNeedyNo")Families
| oo,
- Cash Assistance
....... No ; “egetUFif FICIENT. va abe
Temnpomy Aamitance
Supplemental
fr Nendy Faniis ~ Cech Assiatanes---S &e-
Security income (SSI).nvenveevrcrnnenenernenensrnrerrerneVOR
INS —— : -
7.1 fave been relessed on bail in the amount of § |,.02 1. Cash Surety___ Posted by:Setf__Family__Other__
-_ppersan
punichablswbox knowingly
prowied inprovides
fle orInformation
FS 775.082 775.083. | toattest
the clerkorthe
courtin
seeking
| havea provided
thet the Informationcterrnionof incigent
on this statusfsunder
application FS 27-52
accurateconve
true and to thaarviademennor
of he fet degree,
best of my knowledge. my
Signed or {?. dayot_(¥)_
Z -20 Z7_, ; Signature fos
of Applicant©
< Status
Address,
YOK Last four Gigsweof DeverSe
LORE foI Pee Print
PhoneFulLogalameNs
Number: U7
7 72-2 7 -GOWL =«he
Macrae.
VOR? OPS .
Chy, Ste, Zp Cocte41G,21-4 For PY ermal Aedes: L901 LA
Vento
"7 The Publ 4 pratense ransabovetoa
untl refléved by theiCour,
is hereby gppoinied to the case fisted .© lENJ (V irauicenttNoD
: etermination. og a
oata:_C 2- Clerk of the Circuit Court by
4 oe
Thies " omwasconrapleted
ae withtheessitancect,
oe _GleriiDeputy
moe
Clerkvth
authorized person : :
APPLICANTS FOSLJND NOT TO BE INDIGENT MAY SEEK REVIEW BY A JUDGE BY2A AWEARING THE. pee |
Sign benyou went th
judge to review the clerk's
determination of notindigent.
Oe 4 i .
aia Rev.1077/2020 oJ 2 . Developied by the Ploda CCOC
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St. Lucie County File Date: 04/18/2022 15:51 PM ,
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St. Lucie County File Date: 04/18/2022 15:51 PM eed se .
Document Filed Date
April 18, 2022
Case Filing Date
January 11, 2022
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