New York > Federal > District Court > Western District
Application For Appointment Of Counsel - New York
| Application For Appointment Of Counsel Form. This is a New York form and can be used in Western District District Court Federal . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
UNITED STATES DISTRICT COURT Revised 05/01 WDNYWESTERN DISTRICT OF NEW YORK Plaintiff, ___________-CV-___________ v APPLICATION FOR APPOINTMENT OF COUNSEL Defendant(s). My name is __________________________ ___________________________ and I am the plaintiff in the above action. I hereby apply to the Court for appointment of counsel to represent me in this action. In support of this application, I ask the court to consider the following information: 1. My case concerns the following issue(s) (briefly summarize your case): 2(a). I am unable to retain an attorney to represent me because I do not have the funds to do so. 2(b). [Fill this in if true] I have applied for leave to proceed in forma pauperis. My motion to proceed asa poor person was filed on 2(c). [Fill this in if true] By Court Order filed on ,I was granted leave to proceed as a poor person pursuant to 28 U.S.C. 1915. 3(a). I have attempted to find my own attorney but have been unable to do so because 3(b). I have discussed my case with the following attorneys (include attorneys name and telephone number,and attach any correspondence which indicates that an attorney has declined to represent you): 4. I believe that the following circumstances demonstrate why the Court should grant my request for anappointed attorney: WHEREFORE, plaintiff asks this Court to appoint an attorney to represent plaintiff in this action. I declare under penalty of perjury that the foregoing is true and correct, to the best of my knowledge, information and belief. _____________________________ DATE SIGNATURE
|
|||||||
