Get Sample Indigency Screening Form - South Dakota

The Sample Indigency Screening Form for South Dakota is an essential document for individuals seeking a court-appointed attorney based on their financial situation. This guide will help you navigate each section of the form clearly and effectively.

Follow the steps to accurately complete your form online.

1. Click ‘Get Form’ button to obtain the form and open it in the appropriate platform.
2. Begin by entering your full name in the designated field. This is crucial for identifying your application.
3. Provide your current address, including your city, state, and zip code. If you are homeless, check the box provided.
4. Input your phone number and email address to allow for communication regarding your application.
5. Enter your date of birth in the specified format (MM/DD/YYYY) to verify your age.
6. Fill out your Social Security Number and Driver’s License Number, if applicable. This information assists in verifying your identity.
7. Circle the type of case you are applying for: Criminal, Juvenile Delinquency, CHINS/Abuse & Neglect, or Habeas.
8. If your case is criminal, list the charges in the appropriate space provided.
9. Indicate whether you are currently in jail or a penitentiary by selecting Yes or No.
10. List all types of financial assistance you currently receive by checking the relevant boxes.
11. If you receive any financial assistance, skip to Question 12. Otherwise, answer questions regarding employment and household earnings.
12. Answer employment status and provide your take-home pay and occupation.
13. Specify your total household earnings, considering all individuals who contribute income.
14. Indicate the number of people you financially support within your household.
15. If applicable, provide details regarding home ownership, including the value and debt owed.
16. Indicate the number of vehicles owned and their total value and corresponding debt.
17. State whether you have checking or savings accounts and provide their total value.
18. If you have cash available for hiring an attorney, specify the amount.
19. Disclose any stocks, bonds, or other investments you possess and provide their total value.
20. Detail your total monthly living expenses, including rent, food, utilities, and transportation.
21. Indicate any other monthly expenses you have, such as child support or medical bills.
22. Answer whether you have attempted to hire an attorney and whether you were turned down due to financial reasons.
23. Specify whether you have a friend or relative who can assist with funds for hiring an attorney.
24. Indicate how much you can contribute per week towards hiring a court-appointed attorney.
25. Read the acknowledgment statement, agree to the conditions outlined, and provide your signature and date.
26. Once all fields are completed, save your changes, download the form, print it, or share as needed.

Complete your documents online today to ensure your application is submitted promptly.