THE STATE OF TEXAS
`
`vs
`Tom a;
`
`
`i
`COURT AT LAW NO.
`§
`HARRIS COUNTY, TEXAS
`§
`2) (ML C
`REQUEST vowFOR APPOINTMENT on WAIVER or COUNSEL
`
`CAUSENO. 2’8 7/70
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`L/Pdi
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`§
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`IN THE COUNTY CRIM
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`'.'_‘ the defendant CI ;a witness in this case. Today the judge presiding advised me of
`. I am
`My name is
`my right to be presented by a lawyer, either one that I hire, or ifI am indigent or the interests ofjustice require, a lawyer appointed by the judge
`a well as the procedurefor making this request: and the right to represent‘myself.
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`I believe that I am indigent and I am requesting the Court appoint counsel to represent me. I understand that if there is a material change in my
`znancial circumstances after a determination of my indigence is made, that I, my counsel. or the Assistant District Attorney representing the
`State may ask the judge to reconsider the judge 's decision. In support of this request I am giving sworn testimony before the judge about my
`personal andfinancial circumstances. I understand this information may not be usedfor any purpose except to determine my indigency 'or to
`impeach anyfittttre testimony I may give in this case.
`I received assistance in completing this requestfrom
`E] a court services officer, Cl a court clerk,
`El other
`
`I3 I understand my rig
`myself:
`Signature of De fend
`Sworn to before me on
`
`'r requesting appointed counsel and I choose to waive counsel and represent
`
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`Personal Bond Ofi'ice Employee/Deputy District Clerk. Harris County, Texas
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`Today Defendant's request for appointment of counsel was heard in open court and evidence presented concerning the defendant's financial
`resources.
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`ORDER DETERMINING RIGHT TO APPOINTMENT OF COUNSEL
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`is in the interests ofjustice.
`t.‘ appointment of counsel
`1 Defendant indigent
`The Court FINDS
`The Court FURTH - FINDS Defendant CI IS CI IS NOT financially able to pay all or part of the cost of legal services and related expenses.
`
`The Court FURTHER FINDS there D IS CI IS NO conflict preventing the Public Defender from representing Defendant.
`The Court APPOINTS the
`‘5)
`D Attorney
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`El
`Public Defende
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`named below to represeerll§eTen§tlnifirBfb8rg§stggg§§se¢ the defendant is acquitted, judgmpttt is entered arfl-héfieEN plpfittounced, or
`the army is relnmeesanhebttmoeanamam trader counsel
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`«7 .V
`Attorney
`Ge" (:13) 449 9922 Fax (832) 415 (MW/State Bar#
`Address
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`The Court FINDS Defendant has the financial resources to employ counsel and the appointment of counsel in the interest of justice is not
`necessary; accordingly, the request is DENIED. The Court immediately advised Defendant of the right to a reasonable opportunity to hire a
`lawyer, or that Defendant could waive that right and speak with a prosecutor immediately after this hearing.
`
`Cl Defendant knowingly and voluntarily waived a reasonable opportunity to hire a lawyer and after reading the following, and having it
`explained to him by the Court, sign his name. I have been advised by thejudge ofmy right to representation by counsel in the case pending
`against me. I have beenfitrther advised that ifI am unable to aflord counsel. one will be appointedfor mefree ofcharge. Understanding my
`right to have counsel appointedfor me fi‘ee of charge if I am not financially able to employ counsel, 1 wish to waive that right and request
`the court to proceed with my case without an attorney being appointedfor me. I hereby waive my right to counsel.
`Date:
`Defendant Signature:
`CI Defendant refirsed to sign the waiver.
`Thereafter, 1 informed Defendant of the nature of the charg contained in the information and permitted him to speak with a prosecutor.
`CI Defendant'
`.
`2
`,1 to hire a lawyer was GRANTED.
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`Judge Presiding:
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`,
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`'
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`Date Signed:
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`i 5"le T 9’0 ‘6
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`CCL Form 3
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`05-13-2011
`CLERK
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