Sayreville, MT · Middlesex County
Financial Questionnaire to Establish Indigency
Defendants or their parent or guardian use this questionnaire to provide financial information when applying for indigent defense services or installment payments of fines.
What this form is
This questionnaire lets a defendant, or a parent or guardian for a defendant under 18 or incompetent, apply for indigent defense services or installment payments of fines or penalties. It asks about personal information, employment, income, assets, expenses, liabilities, and attorney costs. Applicants authorize financial verification and certify that their statements are true; the form notes an application fee may apply for indigent defense services.
Who needs it
Defendants seeking indigent defense services or installment payments of fines or penalties, and a parent or guardian completing it for an eligible defendant, use this questionnaire.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the signer dates the certification that the statements are true.
How to submit this form
- 1
Download The Questionnaire
Download the Financial Questionnaire to Establish Indigency PDF.
- 2
Complete The Questionnaire
Fill in the requested personal, employment, income, asset, expense, liability, and attorney information.
- 3
Sign And Date
Sign and date the authorization and certification sections that apply to your request.
- 4
Submit To The City
Submit the completed questionnaire to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Financial Questionnaire to Establish Indigency?
- No. The document has signature and date lines but no notary block; the signer dates a certification that the statements are true.
- How do I submit the Financial Questionnaire to Establish Indigency?
- Submit it to the city department named on the form; check the city website for current contact details.
- What can I apply for with this questionnaire?
- The questionnaire is for indigent defense services or installment payments of fines or penalties. It says an application fee may be charged for indigent defense services.
- What information does the questionnaire request?
- It asks for personal and employment details, income and assets, expenses and liabilities, attorney information, and authorization to verify financial status.