Chenango County, NY · Chenango County
Application for Assigned Counsel Program
This application lets people seeking assigned counsel provide Chenango County with court case details and information about their finances and household.
At a glance
- Issued by
- City of Chenango County · Chenango County, Chenango County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- chenangocountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The application collects court and case information, personal details, employment and income, assets, benefits, and household information for the Assigned Counsel Program. It asks applicants to provide supporting documentation and affirm that their information is true and accurate under penalty of perjury. The form also says the office must be notified immediately if employment status or income changes.
Who needs it
People applying for assigned counsel through Chenango County use this form to provide case, personal, financial, and household information.
How to submit it
The form names the Chenango County Assigned Counsel Office at The Eaton Center, 21 Eaton Ave, 2nd Floor, Norwich, NY 13815. It lists phone, fax, and email contact details but does not specify a submission method.
About notarization
This document is signed without a notary; the applicant signs and dates it and affirms the information is true under penalty of perjury.
How to submit this form
- 1
Download the Application
Download the Application for Assigned Counsel Program PDF.
- 2
Complete the Form
Fill in the court, case, personal, financial, and household information requested.
- 3
Gather Supporting Documentation
The application says supporting documentation is required; gather the documents requested for your application.
- 4
Contact the Assigned Counsel Office
Use the office address or contact details listed on the form to ask how to submit your completed application.
Frequently asked questions
- Who uses the Application for Assigned Counsel Program?
- People applying for assigned counsel through Chenango County use the application to provide court case details, personal information, financial information, and household details.
- What information does the application ask for?
- It asks for court and case information, personal and contact details, employment and income, benefits, assets, household information, and supporting documentation.
- Do I need a notary for the Application for Assigned Counsel Program?
- No. The document is signed and dated without a notary. The applicant affirms that the information is true and accurate under penalty of perjury.
- How do I submit the Application for Assigned Counsel Program?
- The form names the Chenango County Assigned Counsel Office at The Eaton Center, 21 Eaton Ave, 2nd Floor, Norwich, NY 13815. It lists phone, fax, and email details but does not specify how to submit the application.