Office of the Revisor of Statutes

CRIMINAL PROCEDURE

Forms provided here are for reference purposes. To download forms to fill out please visit the Minnesota Courts website.

Upon review of the verified application for a public defender, the Court finds:
	The Defendant is:
	□ Not financially eligible
	□ Financially eligible because:
	□	The defendant, or a dependent of theirs who lives in their household, receives a means tested government benefit.
	□	Due to insufficient funds or other assets, the defendant was refused representation by two lawyers on a referral list maintained by the Court.
	□	The Court does not maintain a lawyer referral list, but two lawyers in this judicial district refused representation of the defendant due to insufficient funds or other assets.
	□	The defendant does not have sufficient income or assets to pay the reasonable costs for defense of their case charged by lawyers in this judicial district.
Therefore, IT IS ORDERED that defendant's application for a public defender is:
	□ Approved
	□ Not approved
The Court finds that reimbursement is:
	□ Not required
	□ Required as follows: _
	□ To be determined at a later date
Date: _			_
			District Court Judge

(Added effective July 1, 1996.)

Minnesota Office of the Revisor of Statutes, 700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155