On January 20, 2021 a
Party Statement
was filed
involving a dispute between
and
Denney, Joseph Wayne,
in the District Court of Charlotte County.
Preview
IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA UW -| [ I- e
BOOKING NUMBER: 202100339
STATE OF FLORIDA vs.
DENNEY, JOSEPH WAYNE
Affidavit for Indigent Status Disclosure Form
Pursuant to Rule 10-2.1 of the Rules Regulating the Florida Bar, before a nonlawyer assists a person in the completion of the
Affidavit of Indigent Status, the nonlawyer shall provide the person with a copy of this disclosure. A copy of the disclosure, signed by
both the nonlawyer and the person, shall be given to the person to retain and the nonlawyer shall keep a copy in the person’s file.
The disclosure does not act as or constitute a waiver, disclaimer, or limitation of liability.
The Deputy Clerk/Pretrial Officer, whose signature appears below, will conduct a Pretrial interview and assist
me with the Affidavit of Indigent Status. The Deputy Clerk/Pretrial Officer has told me and I understand that
the Deputy Clerk/Pretrial Officer:
Is not a lawyer;
May not give legal advice or represent me in court;
Cannot tell me what my rights or remedies are or how to testify in court;
May only help me by asking me factual questions to fill in the blanks on the form;
May also tell me how to file the form;
May only help fill out a form that has been approved by the Supreme Court of Florida.
I can read English
I cannot read English but this disclosure form was read to me by in (language), which
J understand.
INDIGENT “_NOT INDIGENT. The $50.00 application fee is to be paid to the Clerk of Court
You have been found to be _X
within 7 days or it will be added to any cost that may be assessed against you at the conclusion of your case. If you have been found
indigent, the Public Defender will represent you. You must contact them at 350 E. Marion Avenue, Room 1099, Punta Gorda, FL
(941.637.2181) if released. If you are not released, they will contact you at the jail. If found not indigent you may seek judicial
review by asking for a hearing time.
g
01/19/2021 = CF
Signature of Applicant Date = cones
nN
Q re
/ Frank Black/ 01/19/2021 — “
Signature of Deputy Clerk/Pretrial Services Officer Date cid fl T
a
woIN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA y - | } | F
STATE OF FLORIDA vs. BOOKING NUMBER: 202100339
DENNEY, JOSEPH WAYNE
APPLICATION FOR CRIMINAL INDIGENT STATUS
1 AM SEEKING THE APPOINTMENT OF THE PUBLIC DEFENDER
OR
(_=THAVEA PRIVATE ATTORNEY OR AM SELF-REPRESENTED AND SEEK DETERMINATION OF INDIGENCE STATUS FOR COSTS
Notice to Applicant: The provision of a public defender / court appointed lawyer and costs / due process services are not free. A judgement and lien may be
imposed against all real or personal property you own to pay for legal and other services provided on your behalf or on behalf of the person for whom you
are making this application. There is a $50.00 fee for each application filed. If the application fee is not paid to the Clerk of the Court within 7 days, it will
be added to any costs that may be assessed against you at the conclusion of the case. If you are a parent / guardian making this affidavit on behalf of a minor
or tax-dependent adult, the information contained in this application must include your income and assets.
1. [have 2 dependants. (Do not include children not living at home and do not include a working spouse or yourself)
2. [have a take home income of $600.00 paid (X) weekly () bi-weekly () monthly () yearly
(Take home income equals salary, wages, bonuses, commissions, allowances, overtime, tips and similiar payments, minus deductions required by law
and other court ordered support payments)
3. Ihave other income paid (X) weekly () bi-weekly () monthly () yearly: (Circle "Yes" and fill in the amount ifyou have this kind of income, otherwise
circle "No")
Social Security benefits Yes $0.00 NoX _ Veterans’ benefit ‘Yes $0.00 NoX
Unemployment compensation Yes $0.00 NoX — Child support or other regular support ‘Yes $0.00 NoX
Union Funds Yes $0.00 NoX from family members / spouse
Workers compensation Yes $0.00 NoX Rental income Yes $0.00 NoX
‘Trusts or gifts Yes $0.00 NoX _ Dividends or interest Yes $0.00 NoX
Retirement / pensions Yes $0.00 NoX — Other kinds of income not on the list Yes $0.00 NoxX
4. [have other assets: (Circle "yes" and fill in the of the property, otherwise circle "No")
Cash Yes $0.00 NoX — Savings Yes $0.00 NoX
Bank account(s) Yes $0.00 NoX — Stocks / bonds Yes $0.00 NoX
Certificate of deposit or money Yes $0.00 NoX *Equity in homestead real estate Yes $0.00 NoX
market account(s) *Equity in non-homestead real estate
“Equity in Motor vehicle(s) Yes. «0.00 NoX ‘include expectency of an interest in such Yes $0.00 Nox
*Equity in boats/ other tangible Yes $0.00 NoX Property
Property
5. Ihave a total amount of liabilities and debts in the amount of $0.00
6. Lreceive: (Circle "Yes" or "No")
Temporary Assistance for Need;y Families-Cash Assistance Yes $0.00 NoX
Poverty- related veterans’ benefits Yes $0.00 NoX
Supplemental Security income (SSI) ‘Yes $0.00 NoX
7. Thave been released on bail in the amount of $0.00 ( Cash [] Surety Posted by: [] Self [] Family [] Other
A person who knowingly provides false information to the clerk of the court in seeking a determination of indigent status under s, 27.52, F.S. commits a
misdemeanor of the first degree, punishable as provided in s. 775.082, F.S. I attest that the information provided on this Application is true and
accurate.
Sigmon [Ane Ate yD fe ee hs
Signature of Applicant for Indigent Status
Print full name:
Date of Birth 5/27/91 Address: 3552 MIddletown Street Port Charlotte, FL, 33952
Phone: (941) 250-0447 Cell Phone:
Last four digits of Driver's License or ID Number Email Address:
CLERK'S DETERMINATION
Based on the information in the Application, I have determined the applicant to be
[X] The Public Defender is hereby appointed to the case listed above until relieved by the Court.
Indigent [] Not Indigent
Dated this: January 19, 2021
Clerk of the Circuit Court
This form was completed with the assistance of : / Frank Black/
Frank Black 7
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.
Document Filed Date
January 20, 2021
Case Filing Date
January 20, 2021
For full print and download access, please subscribe at https://www.trellis.law/.
Preview
IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA UW -| [ I- e BOOKING NUMBER: 202100339 STATE OF FLORIDA vs. DENNEY, JOSEPH WAYNE Affidavit for Indigent Status Disclosure Form Pursuant to Rule 10-2.1 of the Rules Regulating the Florida Bar, before a nonlawyer assists a person in the completion of the Affidavit of Indigent Status, the nonlawyer shall provide the person with a copy of this disclosure. A copy of the disclosure, signed by both the nonlawyer and the person, shall be given to the person to retain and the nonlawyer shall keep a copy in the person’s file. The disclosure does not act as or constitute a waiver, disclaimer, or limitation of liability. The Deputy Clerk/Pretrial Officer, whose signature appears below, will conduct a Pretrial interview and assist me with the Affidavit of Indigent Status. The Deputy Clerk/Pretrial Officer has told me and I understand that the Deputy Clerk/Pretrial Officer: Is not a lawyer; May not give legal advice or represent me in court; Cannot tell me what my rights or remedies are or how to testify in court; May only help me by asking me factual questions to fill in the blanks on the form; May also tell me how to file the form; May only help fill out a form that has been approved by the Supreme Court of Florida. I can read English I cannot read English but this disclosure form was read to me by in (language), which J understand. INDIGENT “_NOT INDIGENT. The $50.00 application fee is to be paid to the Clerk of Court You have been found to be _X within 7 days or it will be added to any cost that may be assessed against you at the conclusion of your case. If you have been found indigent, the Public Defender will represent you. You must contact them at 350 E. Marion Avenue, Room 1099, Punta Gorda, FL (941.637.2181) if released. If you are not released, they will contact you at the jail. If found not indigent you may seek judicial review by asking for a hearing time. g 01/19/2021 = CF Signature of Applicant Date = cones nN Q re / Frank Black/ 01/19/2021 — “ Signature of Deputy Clerk/Pretrial Services Officer Date cid fl T a woIN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA y - | } | F STATE OF FLORIDA vs. BOOKING NUMBER: 202100339 DENNEY, JOSEPH WAYNE APPLICATION FOR CRIMINAL INDIGENT STATUS 1 AM SEEKING THE APPOINTMENT OF THE PUBLIC DEFENDER OR (_=THAVEA PRIVATE ATTORNEY OR AM SELF-REPRESENTED AND SEEK DETERMINATION OF INDIGENCE STATUS FOR COSTS Notice to Applicant: The provision of a public defender / court appointed lawyer and costs / due process services are not free. A judgement and lien may be imposed against all real or personal property you own to pay for legal and other services provided on your behalf or on behalf of the person for whom you are making this application. There is a $50.00 fee for each application filed. If the application fee is not paid to the Clerk of the Court within 7 days, it will be added to any costs that may be assessed against you at the conclusion of the case. If you are a parent / guardian making this affidavit on behalf of a minor or tax-dependent adult, the information contained in this application must include your income and assets. 1. [have 2 dependants. (Do not include children not living at home and do not include a working spouse or yourself) 2. [have a take home income of $600.00 paid (X) weekly () bi-weekly () monthly () yearly (Take home income equals salary, wages, bonuses, commissions, allowances, overtime, tips and similiar payments, minus deductions required by law and other court ordered support payments) 3. Ihave other income paid (X) weekly () bi-weekly () monthly () yearly: (Circle "Yes" and fill in the amount ifyou have this kind of income, otherwise circle "No") Social Security benefits Yes $0.00 NoX _ Veterans’ benefit ‘Yes $0.00 NoX Unemployment compensation Yes $0.00 NoX — Child support or other regular support ‘Yes $0.00 NoX Union Funds Yes $0.00 NoX from family members / spouse Workers compensation Yes $0.00 NoX Rental income Yes $0.00 NoX ‘Trusts or gifts Yes $0.00 NoX _ Dividends or interest Yes $0.00 NoX Retirement / pensions Yes $0.00 NoX — Other kinds of income not on the list Yes $0.00 NoxX 4. [have other assets: (Circle "yes" and fill in the of the property, otherwise circle "No") Cash Yes $0.00 NoX — Savings Yes $0.00 NoX Bank account(s) Yes $0.00 NoX — Stocks / bonds Yes $0.00 NoX Certificate of deposit or money Yes $0.00 NoX *Equity in homestead real estate Yes $0.00 NoX market account(s) *Equity in non-homestead real estate “Equity in Motor vehicle(s) Yes. «0.00 NoX ‘include expectency of an interest in such Yes $0.00 Nox *Equity in boats/ other tangible Yes $0.00 NoX Property Property 5. Ihave a total amount of liabilities and debts in the amount of $0.00 6. Lreceive: (Circle "Yes" or "No") Temporary Assistance for Need;y Families-Cash Assistance Yes $0.00 NoX Poverty- related veterans’ benefits Yes $0.00 NoX Supplemental Security income (SSI) ‘Yes $0.00 NoX 7. Thave been released on bail in the amount of $0.00 ( Cash [] Surety Posted by: [] Self [] Family [] Other A person who knowingly provides false information to the clerk of the court in seeking a determination of indigent status under s, 27.52, F.S. commits a misdemeanor of the first degree, punishable as provided in s. 775.082, F.S. I attest that the information provided on this Application is true and accurate. Sigmon [Ane Ate yD fe ee hs Signature of Applicant for Indigent Status Print full name: Date of Birth 5/27/91 Address: 3552 MIddletown Street Port Charlotte, FL, 33952 Phone: (941) 250-0447 Cell Phone: Last four digits of Driver's License or ID Number Email Address: CLERK'S DETERMINATION Based on the information in the Application, I have determined the applicant to be [X] The Public Defender is hereby appointed to the case listed above until relieved by the Court. Indigent [] Not Indigent Dated this: January 19, 2021 Clerk of the Circuit Court This form was completed with the assistance of : / Frank Black/ Frank Black 7 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.