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Is your spouse or significant-other employed Yes No Not Applicable Name of employer Employer s address 4. I have attached an affidavit demonstrating my inability to pay the cost of an attorney. I have made the following diligent efforts to obtain legal counsel but have been unsuccessful because of my poverty describe below I need appointed counsel to assist me because describe below Signature Printed Name Date AFFIDAVIT IN SUPPORT OF I answer the following questions under penalty of perjury...
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E-mail and phone refer to the contact information such as email address and phone number.
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The purpose of providing e-mail and phone information is so that individuals or organizations can be reached for communication purposes.
The information that must be reported includes a valid email address and phone number for contact purposes.
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