Application For Post Conviction Relief From Conviction Or Page 6

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PART C
(Fill out this section only if you claim that you are indigent. You must attach a
sworn Financial Statement on form CR-206. Note: AS 18.85.100(c) limits the
appointment of counsel in post conviction relief proceedings. )
I request that the filing fee be partially waived for this application. I am attaching:
1. a filled out CIV-670 PRISONER REQUEST FOR FILING FEE EXEMPTION;
2. a filled out CR-206 FINANCIAL STATEMENT; and
3. a certified copy of my prisoner account statement for the past six months
from the Department of Corrections (DOC).
I request that the court appoint an attorney to represent me in this proceeding
because I cannot afford to pay for one. I understand that:
1. I must attach a filled out CR-206 FINANCIAL STATEMENT to this
application.
I must provide to the court all financial information requested by the court so
the court can decide if I qualify for an appointed attorney. This information
may be made available to the Attorney General after the conclusion of this
proceeding. If I give false information, it may be used to prosecute me for
perjury.
2. If my financial situation changes and I do not report this to the court, the law
requires my appointed attorney to do so.
3. If my application for post conviction relief is denied, the court will enter a
judgment against me which will require me to pay part of the cost of my
*
appointed attorney.
In most cases the court will use the schedule shown
below to determine the amount I will be required to pay. However, in unusual
circumstances, the court may enter judgment against me for more or less
than the scheduled amount. After the judgment is entered, I may request the
court to reduce the amount of the judgment if payment would cause manifest
hardship to me or my family.
Schedule of Costs for Court-Appointed Counsel
Offense of Which Applicant Was Convicted
Class B
Class A or
Murder in the lst
Misdemeanor
or
Unclassified
or 2nd Degree
C Felony
Felony
$250
$250
$500
$750
*
explaining the benefits and costs of court-appointed counsel is
Pamphlet CR-204
available from the court.
Page 6 of 7
CIV-760 (6/14)(cs)
APPLICATION FOR POST CONVICTION RELIEF
AS 12.72.010-.040
FROM CONVICTION/SENTENCE (CRIMINAL RULE 35.1)
Crim. Rule 35.1

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