On September 01, 2021 a
DECLINE PUBLIC DEFENDER SERVICES - REFUSED INTERVIEW
was filed
involving a dispute between
and
Tyree, Daren James,
in the District Court of Charlotte County.
Preview
IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT
IN AND FOR CHARLOTTE COUNTY, FLORIDA
STATE OF FLORIDA vs. BOOKING NUMBER: 202104867
TYREE, DAREN JAMES DATE OF BIRTH: 7/27/1970
i it 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:
e — Isnot 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.
D1 Icanread English
1 I cannot read English but this disclosure form was read to me by in (language), which
understand.
{4 Incapable of Screening - Refused Interview
Signature of Applicant Date
/ Timothy Kelley/ 09/02/2021
Signature of Deputy Clerk/Pretrial Services Officer Date
2 pene
f
Document Filed Date
September 02, 2021
Case Filing Date
September 01, 2021
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IN THE CIRCUIT / COURT OF THE 20th JUDICIAL CIRCUIT IN AND FOR CHARLOTTE COUNTY, FLORIDA STATE OF FLORIDA vs. BOOKING NUMBER: 202104867 TYREE, DAREN JAMES DATE OF BIRTH: 7/27/1970 i it 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: e — Isnot 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. D1 Icanread English 1 I cannot read English but this disclosure form was read to me by in (language), which understand. {4 Incapable of Screening - Refused Interview Signature of Applicant Date / Timothy Kelley/ 09/02/2021 Signature of Deputy Clerk/Pretrial Services Officer Date 2 pene f