On November 02, 2022 a
Request,Application
was filed
involving a dispute between
and
Ashley Rebecca Turner,
for Circuit Criminal Division: CR-C
in the District Court of Duval County.
Preview
IN VHE CLKCULL UK CUUNLY CUURL UP Ln? gupieinL Camcuss ay
AND FOR DUVAL COUNTY, FLORIDA
“Hou.
. STATE OF
“TWUWy,
4
Defendant/Minor Child
1
CASE NO. AIO AUAS
APPLICATION FOR CRIMINAL INDIGENT STATUS
___1 AM SEEKING THE APPOINTMENT OF THE PUBLIC DEFENDER
___T HAVE A PRIVATE ATTORNEY OR AM SELF-REPRESENTED AND SEEK DETERMINATION OF INDIGENCE STATUS FOR COSTS
Notice to Applicant: The provision of a public defender/court app jointed lawyer and costs/due process services are not free. A jud; ment and lien may
be imposed against all real or personal property you own to py for legal and other services provided on your behalf or on behal If of the person for i
r each application filed. If the plication fee is not paid to the Clerk of the Court
;
whom ou are making this application.
within days, it will be adde to any th costs
ere 1s a $50.00 fe
that may be assessed oP
against you at the conclusion of this case. If you are a ps arent/guardian making this
affidavit on behalf of a minor or tax-dependent adul ft, the information contained in this application must include your income and assets.
1. Ihave dependents, (Do not include children not living at home and do not include a working spouse or yourself.)
2. [have a take home income of $ paid ( weekly (_ ) bi-weekly ( semi-month] monthly
f yearly.
ome income equals salary, wa; iges, bonuses, commissions, allowances, overtime, tips and simil r payments, minus de uctions required by law and other f
court ordered support payments.)
I have other income paid( .) weekly ( ) bi-weekly ( ) semi-monthly () monthly (_ ) yearly: (Circle ‘‘Yes’’ and fill in the amount if
you have this kind of income, otherwise circle ‘‘No”’)
Social Security benefits Veterans’ benefit Yes $ No
Unemployment compensation . . Yes $ No Child support or other regular support
Union Funds Yes $ No from family members/spouse No
Workers compensation . Yes $ No Rental income bee Yes $ No
Retirement/pensions. . . Yes $ No Dividends or interest Yes $ No
Trusts or gifts Yes $ No Other kinds of income not on the list . Yes $ No
4 Thave other assets: (Circle ‘“‘Yes”’ and fill in the value of the Property otherwise circle ‘‘No.”’ Use the back of this form to provi de additional information,
Cas! . 10 aVvINgS
Bank account(s) Yes $ No Stocks/bonds Yes$ No
Certificates of deposit or *Equity in Real Estate (excluding homestead). Yes $ No
money market accounts Yes § No *Equity means value minus loans. Also list
*Equity in Motor Vehicles/Boats/ any expectancy in.an interest in such property. .
List the address of this property:
il
ther tangible prope: Yes No
List the year/make/mod lel and tag #..
City, State, Zij
County of Residence
FIE ED
Thave a total amount of liabilities and debts in the amount of $
I receive: (Circle “Yes” or ‘‘No’’) NOV 62 222
Temporary Assistance for Needy Families-Cash Assistance . Yes No
Povel -related veterans’ benefits Yes No
Supplemental Security Income (SSI) Yes No
7. Ihave been released on bail in the amount of $ Cash Surety Posted by: Self __ Family ___ Other
who knowingly rovides false information to the clerk or the court in seeking a determination of indigent status under s.'27.52, F.S.,
A person
commits
provided
f
a misdemeanor 0 the first degree, punishable as provided in s. 775.082, F.S., or s. 775.083, E'S. I attest that the information I have
on this Application is true and accurate to the best of my knowledge.
Signed, this day of » 20.
Signature of Applicant for Indigent Status
Date of Birth Print Full Legal Name
Address
City, State, Zip
Driver’s license or ID number Phone Number
CLERK’S DETERMINATION
: Based on the information in this Application, I have determined the applicant to be ( ) Indigent (- ) Not-Indigent
The Public Defender is hereby appointed to the case listed above until relieved by the Court.
Dated this day of , 20
Clerk of the Circuit Court
This form was completed with the assistance of
Clerk/Deputy Clerk/Other authorized person
APPLICANTS.FOUND NOT INDIGENT MAY SEEK REVIEW BY ASKING FOR A HEARING TIME. Sign here if you want
the judge to review the clerk’s decision of not indigent
omit
WHITR COPY - CLERK PINK cofy - PUBLIC DEFENDER GOLDENROD COPY - DEFENDANT PS-1273
Document Filed Date
November 02, 2022
Case Filing Date
November 02, 2022
Category
Circuit Criminal Division: CR-C
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IN VHE CLKCULL UK CUUNLY CUURL UP Ln? gupieinL Camcuss ay AND FOR DUVAL COUNTY, FLORIDA “Hou. . STATE OF “TWUWy, 4 Defendant/Minor Child 1 CASE NO. AIO AUAS APPLICATION FOR CRIMINAL INDIGENT STATUS ___1 AM SEEKING THE APPOINTMENT OF THE PUBLIC DEFENDER ___T HAVE A PRIVATE ATTORNEY OR AM SELF-REPRESENTED AND SEEK DETERMINATION OF INDIGENCE STATUS FOR COSTS Notice to Applicant: The provision of a public defender/court app jointed lawyer and costs/due process services are not free. A jud; ment and lien may be imposed against all real or personal property you own to py for legal and other services provided on your behalf or on behal If of the person for i r each application filed. If the plication fee is not paid to the Clerk of the Court ; whom ou are making this application. within days, it will be adde to any th costs ere 1s a $50.00 fe that may be assessed oP against you at the conclusion of this case. If you are a ps arent/guardian making this affidavit on behalf of a minor or tax-dependent adul ft, the information contained in this application must include your income and assets. 1. Ihave dependents, (Do not include children not living at home and do not include a working spouse or yourself.) 2. [have a take home income of $ paid ( weekly (_ ) bi-weekly ( semi-month] monthly f yearly. ome income equals salary, wa; iges, bonuses, commissions, allowances, overtime, tips and simil r payments, minus de uctions required by law and other f court ordered support payments.) I have other income paid( .) weekly ( ) bi-weekly ( ) semi-monthly () monthly (_ ) yearly: (Circle ‘‘Yes’’ and fill in the amount if you have this kind of income, otherwise circle ‘‘No”’) Social Security benefits Veterans’ benefit Yes $ No Unemployment compensation . . Yes $ No Child support or other regular support Union Funds Yes $ No from family members/spouse No Workers compensation . Yes $ No Rental income bee Yes $ No Retirement/pensions. . . Yes $ No Dividends or interest Yes $ No Trusts or gifts Yes $ No Other kinds of income not on the list . Yes $ No 4 Thave other assets: (Circle ‘“‘Yes”’ and fill in the value of the Property otherwise circle ‘‘No.”’ Use the back of this form to provi de additional information, Cas! . 10 aVvINgS Bank account(s) Yes $ No Stocks/bonds Yes$ No Certificates of deposit or *Equity in Real Estate (excluding homestead). Yes $ No money market accounts Yes § No *Equity means value minus loans. Also list *Equity in Motor Vehicles/Boats/ any expectancy in.an interest in such property. . List the address of this property: il ther tangible prope: Yes No List the year/make/mod lel and tag #.. City, State, Zij County of Residence FIE ED Thave a total amount of liabilities and debts in the amount of $ I receive: (Circle “Yes” or ‘‘No’’) NOV 62 222 Temporary Assistance for Needy Families-Cash Assistance . Yes No Povel -related veterans’ benefits Yes No Supplemental Security Income (SSI) Yes No 7. Ihave been released on bail in the amount of $ Cash Surety Posted by: Self __ Family ___ Other who knowingly rovides false information to the clerk or the court in seeking a determination of indigent status under s.'27.52, F.S., A person commits provided f a misdemeanor 0 the first degree, punishable as provided in s. 775.082, F.S., or s. 775.083, E'S. I attest that the information I have on this Application is true and accurate to the best of my knowledge. Signed, this day of » 20. Signature of Applicant for Indigent Status Date of Birth Print Full Legal Name Address City, State, Zip Driver’s license or ID number Phone Number CLERK’S DETERMINATION : Based on the information in this Application, I have determined the applicant to be ( ) Indigent (- ) Not-Indigent The Public Defender is hereby appointed to the case listed above until relieved by the Court. Dated this day of , 20 Clerk of the Circuit Court This form was completed with the assistance of Clerk/Deputy Clerk/Other authorized person APPLICANTS.FOUND NOT INDIGENT MAY SEEK REVIEW BY ASKING FOR A HEARING TIME. Sign here if you want the judge to review the clerk’s decision of not indigent omit WHITR COPY - CLERK PINK cofy - PUBLIC DEFENDER GOLDENROD COPY - DEFENDANT PS-1273