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Affidavit of Indigence

  1. Defendant Information
  2. Financial Questionaire
  3. Unsworn Declaration by Defendant

This portion must be completed by DEFENDANT

*Please complete all fields. Incomplete forms cannot be processed.*

This portion must be completed by DEFENDANT

*Please complete all fields. Incomplete forms cannot be processed.*

Your Employment Information

Spouse Employment Information

Second Job Information

Income / Benefits

(Enter $0 If Not Applicable)

Monthly Expenses (Enter 0 If Not Applicable)

Assets

This portion must be completed by DEFENDANT

*Please complete all fields. Incomplete forms cannot be processed.*

I swear that I have personal knowledge of the information I provided in the foregoing questionnaire and that the facts contained therein are true and correct to the best of my knowledge.

Defendant's Oath

I have been advised of my right to representation by counsel in connection with the charge pending against me. I certify that I am without means to employ counsel of my own choosing and I hereby request the court to appoint counsel for me.

Please be aware that some or all of the information that you submit using this form is subject to public disclosure under the Texas Public Information Act. For an overview of this act, visit the Texas Attorney General's website.

Please note that Tarrant County employees are prohibited by law from providing legal advice. If you need legal assistance, call the Tarrant County Bar Association at 817-336-4101 or visit the Tarrant County Bar Association website.

This page was last modified on June 20, 2024