On June 04, 2021 a
Party Statement
was filed
involving a dispute between
and
Didonato, Matthew David,
in the District Court of Charlotte County.
Preview
|
2I- oe F |
IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA
STATE OF FLORIDA vs. BOOKING NUMBER: 202103101
DIDONATO, MATTHEW DAVID DATE OF BIRTH: 8/21/1987
Affidavit rind Lu: |
:
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 fo the person to retain and the nonlawyer shall keep a copy in the persons 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.
Ican read English
1 Icannot read English but this disclosure form was read to me by in (language), which
J understand.
You have been found to be _X__ INDIGENT ~_NOT INDIGENT. The $50.00 application fee is to be paid to the Clerk of Court
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
(241,637.218}) if released. If you are not released, they will contact you at the jail. If found not indigent you may seekJudicial;
review by asking for a hearing time.
1
= ems
wudibly. fedrerby! prem
[Audibly Attested by Deter 4AM,
es) 06/04/2021
jate =
Signature of Applicant ae
/ Benjamin Westrum/ 06/04/2021
Signature of Deputy Clerk/Pretrial Services Officer Date LD
a a a a oo —-+—!) —|-—
IN THE CIRCUIT/ COURT OF THE 20th JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA
STATE OF FLORIDA vs. BOOKING NUMBER: 202103101
DIDONATO, MATTHEW DAVID DATE OF BIRTH: 8/21/1987
APPLICATION FOR CRIMINAL INDIGENT STATUS
& 1AM SEEKING THE APPOINTMENT OF THE PUBLIC DEFENDER.
OR
o 1 HAVE A PRIVATE ATTORNEY OR AM SELF-REPRESENTED AND SEEK DETERMINATION OF INDIGENCE STATUS FOR COSTS I
Notice
to Applicant: The provision of a public defender/ court appointed lawyer and costs/ due process services arc 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. Lhave @ dependants. (Do not include children not living at home and do not include a working spouse or yourself)
2. Ihave a take home income of $0.00 paid (X) weekly () bi-weekly () monthly () yearly
(Take home income equals salary, wages, bonuses, commissions, allowances, overtime, tips and similiar payments, minus deductions reguired by law
and other court ordered support payments)
I have other income paid (X) weekly () bi-weekly () monthly () yearly: (Circle "Yes" and fill in the amount if you 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
from family members/ spouse
Union Funds ‘Yes $0.00 NoX
Workers compensation Yes $0.00 NoX Rental income Yes $0.00
Trusts or gifts ‘Yes $0.00 NoX Dividends or interest ‘Yes $0.00 NoX
Retirement/ pensions Yes $0.0 NoX Other kinds of income not on the list Yes $0.00 NoX
Ihave 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 NoX +include expectency of an interest in such Y¢S $0.00 NoX
$0.00
*Equity in boats/ other tangible “Yes $0.00 NoX property
property
Thave a total amount of liabilities and debts in the amount of $0.00
I receive: (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 $0.00NoX
7. Lhave 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. pee sperma
06/04/2021
(Audibiy At by Defe indant ly Sioned by. AudiblyAi ndant
Signed on 6/4/z cas ee & me
Signature of Applicant for Indigent Status
Print full name:
Date of Birth 8/2/87 Address: 17307 LAKE WORTH BLVD PORT CHARLOTTE, FL, 33948
Phone: (941) 204-7262 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] Indigent 1 Not Indigent
[x] The Public Defender is hereby appointed to the case listed above until relieved by the Court.
Dated this: June 04, 2021
Terk of the Circuit Court
This form was completed with the assistance of {Benjamin Westrum /
Benjamin Westrui
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.
Florida Supreme Court Form 3,984, Updated 11/23/2015
7 a a
Document Filed Date
June 04, 2021
Case Filing Date
June 04, 2021
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| 2I- oe F | IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA STATE OF FLORIDA vs. BOOKING NUMBER: 202103101 DIDONATO, MATTHEW DAVID DATE OF BIRTH: 8/21/1987 Affidavit rind Lu: | : 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 fo the person to retain and the nonlawyer shall keep a copy in the persons 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. Ican read English 1 Icannot read English but this disclosure form was read to me by in (language), which J understand. You have been found to be _X__ INDIGENT ~_NOT INDIGENT. The $50.00 application fee is to be paid to the Clerk of Court 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 (241,637.218}) if released. If you are not released, they will contact you at the jail. If found not indigent you may seekJudicial; review by asking for a hearing time. 1 = ems wudibly. fedrerby! prem [Audibly Attested by Deter 4AM, es) 06/04/2021 jate = Signature of Applicant ae / Benjamin Westrum/ 06/04/2021 Signature of Deputy Clerk/Pretrial Services Officer Date LD a a a a oo —-+—!) —|-— IN THE CIRCUIT/ COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA STATE OF FLORIDA vs. BOOKING NUMBER: 202103101 DIDONATO, MATTHEW DAVID DATE OF BIRTH: 8/21/1987 APPLICATION FOR CRIMINAL INDIGENT STATUS & 1AM SEEKING THE APPOINTMENT OF THE PUBLIC DEFENDER. OR o 1 HAVE A PRIVATE ATTORNEY OR AM SELF-REPRESENTED AND SEEK DETERMINATION OF INDIGENCE STATUS FOR COSTS I Notice to Applicant: The provision of a public defender/ court appointed lawyer and costs/ due process services arc 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. Lhave @ dependants. (Do not include children not living at home and do not include a working spouse or yourself) 2. Ihave a take home income of $0.00 paid (X) weekly () bi-weekly () monthly () yearly (Take home income equals salary, wages, bonuses, commissions, allowances, overtime, tips and similiar payments, minus deductions reguired by law and other court ordered support payments) I have other income paid (X) weekly () bi-weekly () monthly () yearly: (Circle "Yes" and fill in the amount if you 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 from family members/ spouse Union Funds ‘Yes $0.00 NoX Workers compensation Yes $0.00 NoX Rental income Yes $0.00 Trusts or gifts ‘Yes $0.00 NoX Dividends or interest ‘Yes $0.00 NoX Retirement/ pensions Yes $0.0 NoX Other kinds of income not on the list Yes $0.00 NoX Ihave 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 NoX +include expectency of an interest in such Y¢S $0.00 NoX $0.00 *Equity in boats/ other tangible “Yes $0.00 NoX property property Thave a total amount of liabilities and debts in the amount of $0.00 I receive: (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 $0.00NoX 7. Lhave 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. pee sperma 06/04/2021 (Audibiy At by Defe indant ly Sioned by. AudiblyAi ndant Signed on 6/4/z cas ee & me Signature of Applicant for Indigent Status Print full name: Date of Birth 8/2/87 Address: 17307 LAKE WORTH BLVD PORT CHARLOTTE, FL, 33948 Phone: (941) 204-7262 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] Indigent 1 Not Indigent [x] The Public Defender is hereby appointed to the case listed above until relieved by the Court. Dated this: June 04, 2021 Terk of the Circuit Court This form was completed with the assistance of {Benjamin Westrum / Benjamin Westrui 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. Florida Supreme Court Form 3,984, Updated 11/23/2015 7 a a