Defendant's Financial Statement on Eligibility for Appointment of Counsel and Reimbursement and Record on Appeal at Public Expense (CR-105)

Tells the court that you are eligible to: (1) have an attorney appointed to you because you cannot afford one; (2) be reimbursed for the cost of a court-appointed attorney; or (3) receive a copy of the court reporter's transcript at the public's expense. Use this form to list your assets, income, and expenses for the court to consider in making a decision on this request.