agcr012610 - lake view man pleads guilty to aggravated misdemeanor identity theft.pdf

8/10/2019 AGCR012610 - Lake View man pleads guilty to Aggravated Misdemeanor Identity Theft.pdf

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E-FILED 2014 JUL 29 11:29 AM SAC - CLERK OF DISTRICT COURT


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1 VIA

FILED

JUL

3 P H 3 : M

2DU

IN

T H E I O W A D I S T R I C T

C O U R T

F O R .

Sac

C O U N T Y

S T A T E

O FI O W Aor

PlaintiftTPetitioner,

Defendant/Respondent.

Criminal Civil

No.

F I N A N C I A L A F F I D A V I T /A P P L I C A T I O N

F O R A P P O I N T M E N T O F C O U N S E L

In

supporto f

myapplication

for appointment ofcounsel,and under penaltyof

perjury,

the undersigned

states:

Name: ^~k\Ck&

E-mail: l

:

< l v N

$ / W

V

V i ^

StreetAddress:

Street/P.O.Box

Apt

#

City

Pendingcharges: J L Q - V l - . )4'

:

i > f ^ / A '

Do you

have

ajob?

N o

Job B[

Yes,

Full

Time

Yes.

Part

Time(ListHours/week:

State Zip

InJail?

^Yes No

)

Who do you

work

for?

How muchmoneydo you

currently

make before taxes or deductions? \ per JSyhour month year

How muchmoney haveyoumadeinthe last12monthsfromany source, before taxes or deductions? A / /A

How

manyfamilymembers are supported

by

orlivewith

you?

If aspouseliveswithyou, howmuchmoney doesyourspouse make?

7

j * per hour month year

List allother money

you

agcr012610 - lake view man pleads guilty to aggravated misdemeanor identity theft.pdf

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