FORM 8.932. APPLICATION FOR COUNSEL AND ORDER

APPLICATION FOR COUNSEL
AND ORDER
STATE OF FLORIDA
COUNTY OF ....................
Before me, the undersigned authority, personally appeared
affiant, who, being duly sworn, says:

1. That I understand a delinquency complaint has been
made against me and, being advised of my right to an attorney, now
request appointment of counsel.

2. Being without sufficient funds, property or assets of any
kind, I will be deprived of my right to representation unless I am
adjudged insolvent and counsel appointed to represent me.

3. That I have been informed that a lien for the value of the
legal services rendered to me by the public defender may be
imposed by law on any property I now or may hereafter have in this
state.

Dated: ....................



Affiant Child
STATEMENT OF PARENT(S)
The undersigned are informed and understand that liability for
cost of representation of this child by the public defender can be
assessed against the parent(s) by court order in an amount not to
exceed the amount provided by law.



Parent


Parent
ORDER
The court finds that this child is indigent, as defined by law,
and is desirous of counsel; it is, therefore,

ORDERED

1. That this child is declared to be insolvent.

2. That ...................., Public Defender for the ..... Judicial
Circuit, State of Florida, is hereby appointed as counsel to
represent this child in all matters in defense of the delinquency
complaint herein made.

DONE AND ORDERED in the circuit court in and for
.................... County, Florida, on .....(date)......



Circuit Judge