Application Affidavit For Public Defender Services And Promise To Pay (Page 2 of 2) in pdf

FEES

I understand that if I am accepted as a client by the Missouri State Public Defender (MSPD), I will owe a fee as set

out in the chart below, even if I hire a private attorney after I apply for and am accepted by the Public Defender.

Entry with early withdrawal

$25

Misdemeanors and Probation Violation Cases

$125

Felonies, Appeals and Post-Conviction Relief

$375

Felony Sex Cases

$500

Murder Non-Capital and Civil Commitment Cases

$750

Capital Murder Case

$1,500

ACKNOWLEDGMENT AND PROMISE TO PAY

I understand that lying on this application constitutes a crime. I also understand that MSPD may contact

government agencies, credit bureaus, employers, banks, or other financial institutions to verify my financial

situation. My signature constitutes authorization for release of this information to MSPD.

By signing, I agree that I am requesting the Public Defender to represent me, and that I agree and promise to pay

the sum set out in the Fee section above. I understand that MSPD may collect this fee in this case and other cases

where the Public Defender has undertaken representation based on this application from monies payable to me

such as income tax refunds and/or lottery winnings. Additionally, I consent to MSPD utilizing electronic

communication regarding my case.

I understand that if accepted, I am entitled to my legal file at the conclusion of my case and that if I do not request

my file within 10 years from the conclusion of representation, it may be destroyed.

_________________________________________________________

______________________________

Applicant Signature

Date

NOTICE

Every person charged or under suspicion of committing a crime punishable by jail or imprisonment is entitled to

a lawyer. If you cannot afford to hire a lawyer without substantial financial hardship to you or your dependents,

the state will provide a lawyer for you if:

You are detained or charged with a felony, including appeals from a felony conviction;

You are detained or charged with a misdemeanor which will probably result in confinement in jail, including

appeals from a conviction in such a case;

You are detained or charged with a violation of probation and the judge determines your due process rights

require a lawyer;

When the federal constitution, state constitution or any law of this state requires the appointment of a lawyer.

Be advised that MSPD uses electronic communication. Be aware that: (1.) electronic communication is not a secure method of

communication; (2.) any electronic communication that is sent to you or by you may be copied and held by any or all computers or other

devices through which it passes as it is transmitted; and, (3.) persons not participating in our communication may intercept our

communications by improperly accessing either of our computers or other devices or another computer or device unconnected to either of

us through which the electronic communication has passed. In the event you do not wish this form of communication, please notify MSPD;

until such notification is received, MSPD may communicate with you electronically.

____________________________________________________________________________________________________

For MSPD Use Only – DO NOT COMPLETE

Indigent______ Not Indigent ______ Signed: ____________________________ Dated: ________________

MO 151-0226 (01/16)

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Application Affidavit For Public Defender Services And Promise To Pay Page 2

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