APPLICATION FOR THE APPOINTMENT OF COUNSEL - Court Forms - Offenses, faults or civil matters

Sep 17, 2026

Uploaded by Angel

Application form from Puerto Rico’s Commonwealth courts requesting assignment of court-appointed counsel. The applicant or authorized representative asks the Court to provide legal representation because free legal services were denied and the applicant lacks financial means. The form includes sworn declarations under penalty of perjury, completion instructions, and sections for personal information, custody or hospitalization status, incapacity declarations, in forma pauperis rulings, and detailed employment and financial information with documentation requirements.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

APPLICATION FOR THE APPOINTMENT OF COUNSEL

A. INFORMATION OF THE PERSON FOR WHOM THIS APPLICATION IS SUBMITTED

B. EMPLOYMENT AND FINANCIAL INFORMATION

Commonwealth of Puerto Rico GENERAL COURT OF JUSTICE Court of Appeals Court of First Instance, Superior Part Municipal Part of CASE NO. Re: Offenses, faults or civil matters APPLICATION FOR THE APPOINTMENT OF COUNSEL To the Honorable Court: Now comes : the applicant [person for whom this application is filed], the applicant’s representative, or the underage applicant, represented by his/her mother, father, legal guardian , or other person with custody, and respectfully requests that this Court assign a court-appointed counsel in this case, since legal representation was denied by entities offering free legal services and the applicant does not have the financial means to defray the services of an attorney. In support of this application , I declare , under penalty of perjury, that the answers provided below are true. INSTRUCTIONS: Complete all questions in this form and sign it. Do not leave any questions in blank. If the answer to a question is “0", “none” or “not applicable (N/A),” write-in that response. If you need more space to answer a question or to explain your answer, attach a separate sheet of paper identified with your name, your case docket number, and the question number. | A. INFORMATION OF THE PERSON FOR WHOM THIS APPLICATION IS SUBMITTED | | --- | | Name Initial First Last Name Second Last Name
Date of Birth (day/month/year): Age: Sex: Civil Status: married single divorced widow/er
separated in a consensual relationship
Can the applicant read? Yes No Can the applicant write? Yes No
Highest degree completed: Professional or vocational formation: Physical Address:

Mailing Address: Email Address:
Telephones: ( ) Mobile ( ) Residential Is the applicant currently remanded in custody? Yes No
If yes, provide the name of the institution: Is the applicant admitted to hospital or in psychiatric or correctional institution? Yes No If yes, provide the name of the institution:
Has the applicant been declared incapacitated by a court? Yes No
If yes, provide the date of the judicial declaration of incapacity (day/month/year) , the issuing court, and the case docket number:

Has a court issued a ruling to litigate as an indigent party (in forma pauperis) in this case? Yes No
If yes, provide the date of the court ruling (day/month/year): | | B. EMPLOYMENT AND FINANCIAL INFORMATION OF THE PERSON FOR WHOM THIS APPLICATION IS SUBMITTED , HIS/HER SPOUSE, PARENTS, LEGAL GUARDIAN , OR PERSON WITH CUSTODY, IN THE CASE OF A MINOR (Please specify each source of income and attach proof thereof, such as pay stubs, employment verification, cheques, bank statements, tax returns, certifications issued by the Municipal Revenue Collection Center (CRIM), certifications issued by the Child Support Administration (ASUME), contracts, etc.) | | --- | | State whether the applicant is currently employed: Yes No If yes , fill out the following information:
Occupation: Name of Employer: Address:

Telephone: ( ) Ext. Salary: $ weekly bi-weekly every 15 days monthly Is the applicant currently on unpaid leave? Yes No
If yes, state the period of the leave granted and the reason:

Does the applicant own a business? Yes No If yes, fill out the following information:
Name and type of business: Address:

Telephone: ( ) Ext.
Is the applicant self-employed? Yes No If yes, fill out the following information:
Type of business: Address:

Telephone: ( ) Ext.
If the applicant is unemployed, provide the date last employed (day/month/year): Provide the name of the employer, position, address, and monthly salary of the last employment:

List employment experience during the last three (3) years (include the name of the employer, address, date of employment, position, and monthly salary for each):

State whether the spo

FAQs

What is this application requesting from the court?

It requests that the Court assign a court-appointed counsel in the case due to denial of free legal services and the applicant’s inability to pay an attorney.

Who may file or represent the applicant?

The applicant, the applicant’s representative, or an underage applicant represented by a parent, legal guardian, or other person with custody may file the application.

What must the applicant do before submitting?

Complete all questions, sign the form, do not leave questions blank, and if a response is “0,” “none,” or “not applicable (N/A),” write that exact response.

Sep 17, 2026

Uploaded by Angel