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Advice Concerning Right To Appeal After Plea Of Guilty Or Nolo Contendere CC 265b - Michigan
| Advice Concerning Right To Appeal After Plea Of Guilty Or Nolo Contendere Form. This is a Michigan form and can be used in Appeals Statewide . |
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Original - Trial court 1st copy - Prosecutor Approved, SCAO 2nd copy - Defendant/Juvenile for return 3rd copy - Defendant/Juvenile STATE OF MICHIGAN CASE NO. JUDICIAL CIRCUIT ADVICE CONCERNING RIGHT TO APPEAL AFTER PLEA OF GUILTY/ COUNTY NOLO CONTENDERE Judge: Court address Court telephone no. Defendant/Juvenile name, address, telephone no., and date of birth THE PEOPLE OF THE STATE OF MICHIGAN v 1. You are entitled to file an application for leave to appeal with the Court of Appeals. You are being given an Application for Leave to Appeal form and instructions for completing it. You are not entitled to have a lawyer appointed at public expense to assist you in filing an application for leave to appeal or to assist you with other post-conviction remedies unless you meet the requirements in item 2 below. Michigan Court Rule requires you to file your Application for Leave to Appeal within 21 days of sentencing, but you have 12 months to file a late appeal under MCR 7.205(F)(3). 2. If you are financially unable to retain a lawyer, the court must appoint a lawyer to represent you on appeal if: a. your sentence exceeds the guidelines, or b. your plea is a conditional plea under MCR 6.301(C)(2), or c. the prosecuting attorney seeks leave to appeal, or d. the Court of Appeals or the Supreme Court grants leave to appeal. 3. The request for a lawyer must be completed and sent directly to the court at the address noted above within 42 days after sentencing. The financial schedule on the back of this form must be completed. RECEIPT OF NOTICE OF APPEAL RIGHTS AND APPLICATION FOR LEAVE TO APPEAL On this day I received this form and financial schedule and an application for leave to appeal. I understand that I must return the completed Request for Appointment of Lawyer to the court within 42 days if I want an attorney appointed for my appeal. Date Signature of defendant/juvenile REQUEST FOR APPOINTMENT OF LAWYER AND AFFIDAVIT OF INDIGENCY I request appointment of an attorney to appeal my conviction. Conditions for my request are on the back of this form. The affidavit of indigency and financial schedule on the back of this form is submitted to show my financial condition. I request the court waive the filing fee for my application for leave to appeal. Date Signature of defendant/juvenile NOTE TO DEFENDANT/JUVENILE: After completing the request for appointment of lawyer and the affidavit of indigency and financial schedule, keep one copy for yourself and return the other copy to the court. MCL 770.3a, MCR 6.302(B)(6), MCR 6.425(E), MCR 7.205(F)(3)CC 265b (6/03) ADVICE CONCERNING RIGHT TO APPEAL AFTER PLEA OF GUILTY/NOLO CONTENDERE <<<<<<<<<********>>>>>>>>>>>>> 2 AFFIDAVIT OF INDIGENCY AND FINANCIAL SCHEDULE I request a court appointed attorney and submit the following information: 1. RESIDENCE Rent Own Live with parents Room/Board Prison Number 2. MARITAL STATUS Single Married Divorced Separated Dependents: Number3. INCOME a. Employer name and address b. Length of employment c. Average of pay weekly monthly every two weeks Gross: $ Net: $ d. Other income (state monthly amount and source [FIA, VA, rent, pensions, spouse, unemployment, etc.]) If no income, state NONE.4. ASSETS State value of car, home, bank deposits, inmate accounts, bonds, stocks, etc. If no assets, state NONE. Attach an account statement and certification for assets in prison accounts. 5. OBLIGATIONS Itemize monthly rent, installment payments, mortgage payments, child support, etc. 6. REIMBURSEMENT I understand that I may be ordered to reimburse the court for all or part of my attorney and defense costs.7. I pled guilty, guilty but mentally ill, or nolo contendere and I believe I am entitled to an attorney at public expense based on the following circumstance as stated in item 2 on the other side of this form: a. my sentence exceeds the guidelines. b. my plea was a conditional plea made under MCR 6.301(C)(2). c. the prosecuting attorney seeks leave to appeal. d. the Court of Appeals or the Supreme Court grants my leave to appeal. Signature Address Name (type or print) City, state, zip Subscribed and sworn to before me on , County, Michigan Date My commission expires: Signature: Date Notary public
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