Wayne County, NY · Wayne County
Application for Assignment of Counsel
Wayne County residents seeking assigned counsel can use this application to provide personal, case, employment, income, expense, and asset information.
At a glance
- Issued by
- City of Wayne County · Wayne County, Wayne County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- waynecountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This application helps the Wayne County Public Defender and court screener assess whether an applicant qualifies for assigned counsel. Applicants complete Part I with personal, current case, and employment details; the form says to submit the first page and await further instructions. If required, Part II asks for monthly expenses, other income, and assets, while a court screener records eligibility decisions.
Who needs it
People applying for assigned counsel for a criminal case in Wayne County use this form to provide information for an eligibility screening.
How to submit it
Complete the first page and email the application to [email protected]. The form says to await further instructions; it does not list a fee.
About notarization
This application is signed and dated without a notary; the form includes no notarized or sworn attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download the Application
Download the Application for Assignment of Counsel PDF.
- 2
Complete the First Page
Fill in the requested personal, current case, and employment information, then sign and date Part I.
- 3
Await Further Instructions
The form says to submit the first page and await further instructions about whether Part II is required.
- 4
Email the Application
Email the completed application to [email protected].
Frequently asked questions
- Do I need a notary for the Application for Assignment of Counsel?
- No. The application has signature and date fields but no notary block or notarized attachment; the signer just signs and dates it.
- How do I submit the Application for Assignment of Counsel?
- Complete the first page and email it to [email protected]. The form says to await further instructions.
- What information does the application request?
- It asks for personal and current case details, employment information, and, if Part II is required, monthly expenses, other income, and assets.