On September 02, 2021 a
DECLINE PUBLIC DEFENDER SERVICES - REFUSED INTERVIEW
was filed
involving a dispute between
and
Kingcade, Marjesta Quintin,
for Out of County
in the District Court of Charlotte County.
Preview
IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA Q- ay op
STATE OF FLORIDA vs. BOOKING NUMBER: 202104880
DATE OF BIRTH: 8/28/1980
KINGCADE, MARJESTA QUINTIN
for indige: atus Disclosure Form
ida’
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; a
* May also tell me how to file the form; ca
* May only help fill out a form that has been approved by the Supreme Court of Florida. w
gq
'
(1 Ican read English ind
=
1 _Icannot read English but this disclosure form was read to me by in (language), whick a
eg° =
Ba OS
J understand.
Incapable of Screening - Refused Interview
Signature of Applicant Date
/ Timothy Kelley/ 09/03/2021
Date
Signature of Deputy Clerk/Pretrial Services Officer
{MAS
Ke
Document Filed Date
September 03, 2021
Case Filing Date
September 02, 2021
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IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA Q- ay op STATE OF FLORIDA vs. BOOKING NUMBER: 202104880 DATE OF BIRTH: 8/28/1980 KINGCADE, MARJESTA QUINTIN for indige: atus Disclosure Form ida’ 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; a * May also tell me how to file the form; ca * May only help fill out a form that has been approved by the Supreme Court of Florida. w gq ' (1 Ican read English ind = 1 _Icannot read English but this disclosure form was read to me by in (language), whick a eg° = Ba OS J understand. Incapable of Screening - Refused Interview Signature of Applicant Date / Timothy Kelley/ 09/03/2021 Date Signature of Deputy Clerk/Pretrial Services Officer {MAS Ke