Illinois Administrative Code (Last Updated: March 27, 2024) |
TITLE20. CORRECTIONS, CRIMINAL JUSTICE, AND LAW ENFORCEMENT |
PART2000. POLICY, HEARINGS AND FORMS |
§2000.APPENDIX G. Application and Order for Appointed Counsel Based Upon Indigency
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IN RE: TIRC Claim No.:
APPLICATION FOR APPOINTED COUNSEL BASED UPON INDIGENCY
I,
, on oath state:
1.
I am employed as a(n)
by
.
2.
My other sources of income (including spouse's income) or support are:
..
3.
The amount of income that I expect for this year is $
.
4.
My income for the previous year was $
.
5.
The persons dependent on me for support are
.
6.
My other sources of income are:
Assistance Foster Care Aid to Aged, Blind and Disabled Temporary
Assistance for Needy Families General Assistance State Transitional Assistance
State Children and Family Services Other:
$
(per month).
7.
The nature and value of property I own includes:
Real Estate (Describe property,
specify address, present value and mortgage liens outstanding.)
Year
Value $
8.
My monthly living expenses, including payments of debts and child support, are $
9.
I am unable to pay the cost of counsel for this claim and to do so would cause a substantial
hardship on me and my family.
Signature of Applicant
ILLINOIS TORTURE INQUIRY AND RELIEF COMMISSION
ORDER
IN RE: TIRC Claim No. :
The Claimant, having demonstrated indigency, is appointed counsel for the limited purpose of advising Claimant regarding the Waiver procedure set forth in 2 Ill. Adm. Code 3500.350, and, if a Formal Inquiry is initiated pursuant to 2 Ill. Adm. Code 3500.375, regarding the Formal Inquiry as long as the Claim is pending before the Torture Inquiry and Relief Commission. Counsel is appointed to advise Claimant only with regard to Claimant's pending Claim before the Commission, and not about any other legal matters Claimant may have.
The Claimant's Application for appointed counsel is denied because the Application fails to demonstrate indigency.
Date
TIRC Chair