Ariz. R. Crim. P. form 5(b)
___________________COURT | [Precinct _____] | ____________County, Arizona |
STATE OF ARIZONA Plaintiff | [CASE/COMPLAINT NO.] | |
-vs- | MOTION FOR | |
APPOINTMENT | ||
OF COUNSEL | ||
Defendant (FIRST, MI, LAST) | ||
MOTION FOR APPOINTMENT OF COUNSEL | ||
Defendant moves for the appointment of Counsel and declares that Defendant's financial circumstances will not allow the hiring of a private attorney in this case. | ||
Signature ________________ | Date _________________ | Phone No. _______________ |
Address ________________________________________ | ||
______________________________________________________________ | ||
ORDER | |
[ ] | Motion for Court Appointed Counsel is granted. |
(Check if applicable) | |
[ ] A financial assessment is ordered for a recommendation to the Court as to defendant's eligibility and any contribution amount to the cost of the court appointed attorney. | |
[ ] $ __________ for financial assessment. | |
[ ] $ __________ for contribution to the cost of the court appointed attorney. | |
[ ] Legal Services to be provided by ________________________________ | |
Phone No. ___________________________________ | |
[ ] | Motion for court appointed attorney is denied. |
Judicial Officer ____________________ | Date _____________________ | Courtroom ___________ |
Form 5(b)
Ariz. R. Crim. P. form 5(b)