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UNITED STATES DISTRICT COURT S (US Courts)

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Rev. 3/27/14
UNITED STATES DISTRICT COURT
S
OUTHERN DISTRICT OF NEW YORK
_____CV__________ (_____) (_____)
Application for the Court to
Request Pro Bono Counsel
(List the full name(s) of the plaintiff(s)/petitioner(s).)
-against-
(List the full name(s) of the defendant(s)/respondent(s).)
I ask the Court to request a pro bono attorney to represent me in this action. In support of my
application, I declare under penalty of perjury that the following information is true and correct:
1. Have you previously filed a “Request to Proceed in Forma Pauperis” (an IFP application)?
Please check the appropriate box below:
☐ I have previously filed an IFP application in this case, and it is a true and correct
representation of my current financial status.
☐ I have not previously filed an IFP application in this case and now attach an original IFP
application showing my financial status.
☐ I have previously filed an IFP application in this case, but my financial status has
changed. I have attached a new IFP application showing my current financial status.
2. Explain why you need an attorney in this case. (Please note that requests for pro bono
counsel are rarely granted at the early stages of a case and usually not before the Court has
issued a decision on the merits of the case.) If you asked for an attorney earlier in this case,
please also explain what has changed since you last asked for an attorney.
2
3. Explain what steps you have taken to find an attorney and with what results. (Please identify
the lawyers, law firms or legal clinics you have contacted and their responses to your
requests. If you have limited access to the telephone, mail, or other communication methods,
or if you otherwise have had difficulty contacting attorneys, please explain.)
4. If you need an attorney who speaks a language other than English, state what language(s) you
speak: ____________________________________________________________.
5. I understand that if an attorney volunteers to represent me and that attorney learns that I can
afford to pay for an attorney, the attorney may give this information to the Court.
6. I understand that even if the Court grants this application, I will receive pro bono counsel
only if an attorney volunteers to take my case and that there is no guarantee that an attorney
will volunteer to represent me.
7. I understand that if my answers on this application or in my IFP application are false, my
case may be dismissed.
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Completed 27 May 2021

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