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Lawyer Guardian ad litem Court Visitor Child &

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The Lawyer Guardian ad litem Court Visitor Child & form is 3 pages long and contains:

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  • 14 check-boxes
  • 84 other fields

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File type: PDF

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www.courts.state.co.us/forms
JDF 208 – Request for State Paid Professional R: December 21, 2020 Page 1 of 3
JDF 208
Request for a State Paid Professional
County: ________________________
Division: ______
Court Use Only
Case Number: ___________________
Courtroom: ____
Because I (or they) can’t afford one, I would like the court to provide a state paid:
Lawyer Guardian ad litem Court Visitor Child & Family Investigator
For: Me/My Case or Another Party. (Fill in their information in sections 2-8 below.)
1. I understand
• I must fill in all blanks. Write “No” or “None” if a blank doesn’t apply.
• The court may charge a $25 processing fee at the end of the case.
• I/They may have to repay the state for the professional’s fees.
2. Basic Information
Name: _________________________________ Birthdate: ______________
Mailing Address: ____________________________________________________
Street Address: (if different) ______________________________________________
City, State, Zip: _____________________________________________________
Phone number: ___________________ Email: __________________________
3. Work Information
Job Title: ______________________ Company: ________________________
Work Address: _____________________________________________________
City, State, Zip: _____________________________________________________
Work Phone: _________________________ Length of Employment: ____________
Pay Date(s): _____________ Hours/Week: ________ Pay Rate: $ ___________
4. Case Information
Next hearing: (type and date) _____________________________________________
Most serious charge: (criminal cases only) _____________________________________
www.courts.state.co.us/forms
JDF 208 – Request for State Paid Professional R: December 21, 2020 Page 2 of 3
5. Household Members
Status: Single Married or Civil Union Partnered
Separated Divorced
Number of dependents: (including yourself) _______________.
Note - Don’t list roommates. Only list household members who contribute income to the common support of the home.
Name
Relationship
Income Before Taxes
_____________________
______________________
$ ____________________
_____________________
______________________
$ ____________________
_____________________
______________________
$ ____________________
_____________________
______________________
$ ____________________
6. Monthly Income & Expenses
$
Expenses
$
$ ______
Rent/Mortgage
$ ______
$ ______
Groceries
$ ______
$ ______
Utilities
$ ______
$ ______
Clothing
$ ______
$ ______
Maintenance/Child Support
$ ______
$ ______
Medical/Dental
$ ______
$ ______
Transportation
$ ______
$ ______
Loans/Credit Cards
$ ______
$ _______
Total Expenses
$ _______
0.00
0.00
www.courts.state.co.us/forms
JDF 208 – Request for State Paid Professional R: December 21, 2020 Page 3 of 3
7. What is Owned
Asset
$
Value
Description of Asset
$ Still
Owed
Savings Account
$ _______
Bank Name: ___________________
Checking Account
$ _______
Bank Name: ___________________
Vehicle
$ _______
Year & Model: _________________
$ ______
Vehicle
$ _______
Year & Model: _________________
$ ______
House
$ _______
Type: _________________________
$ ______
Other Property
$ _______
Type: _________________________
$ ______
Stocks, Bonds, and
Mutual Funds
$ _______
Type: _________________________
Other Investments
$ _______
Type: _________________________
$ ______
Total Assets
$ ________
Convertible to Cash
$ _______
8. References
1) Name/Phone/Email: ______________________________________________
2) Name/Phone/Email: ______________________________________________
9. Sign & Date
I swear that the information contained above is true and complete.
_________________________ ________________________ _____________
Print Your Name Your Signature Date
Staff Use Only:
Above Guidelines At or Below Guidelines
Staff Signature: __________________________________________________ Date: _______________________
Request Granted Request Denied
Judicial Officer Signature: __________________________________________ Date: _______________________
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www.courts.state.co.us/forms
JDF 208 (I) – Form Instructions R: December 21, 2020 Page 1 of 1
Instructions
1. Income Before Taxes
Includes income from household members who contribute to the common support of the home.
Include:
• Wages
• Tips
• Salaries
• Bonuses
• Alimony
• Pensions
• Royalties
• Annuities
• Dividends
• Commissions
• Capital Gains
• Severance Pay
• Trust Income
• Retirement Benefits
• Unemployment Benefits
• Independent Contractor Pay
• Social Security Disability (SSD)
• Social Sec. Supplemental Income (SSI)
• Interest/Investment Earnings
• Worker’s Compensation Benefits
Note: Don’t include income from roommates. Only include their incomes if you share
bank accounts or commingle funds.
Do Not Include:
• Food Stamps
• Child Support
• Public Assistance
• TANF Payments
• Subsidized Housing
• Veteran’s Disability
2. Liquid Assets/ Convertible to Cash
Includes cash on hand or in accounts, stocks, bonds, certificates of deposit, and equity.
This also includes personal property or investments that could be converted into cash without risking
your ability to maintain a home and employment.
3. Expenses
Do not include nonessential items such as cable, streaming services, club memberships, entertainment,
dining out, alcohol, cigarettes, etc. Allowable expense categories are listed on the form.
4. Attach
You may have to provide the three previous month’s bank statements and proof of income (like pay
stubs). Don’t attach original documents. You may wish to remove financial account and tax
identification numbers.
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Completed 5 February 2021

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