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The Financial Affidavit CJA-23 form plays a crucial role in the judicial system, particularly for individuals seeking court-appointed representation under the Criminal Justice Act (CJA). This form helps determine whether a defendant qualifies for free legal services based on their financial situation. By providing detailed information about income, expenses, assets, and liabilities, the CJA-23 allows the court to assess an individual's ability to afford private counsel. Completing this affidavit accurately is essential, as it directly impacts the court's decision regarding the appointment of a public defender. Additionally, the form requires individuals to disclose any dependents and other financial obligations, ensuring a comprehensive view of their economic status. Understanding the nuances of the CJA-23 is vital for anyone navigating the complexities of the legal system, as it not only influences access to justice but also highlights the importance of equitable representation in criminal proceedings.

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CJA-23

FINANCIAL AFFIDAVIT

(Rev 3/21)

 

IN SUPPORT OF REQUEST FOR ATTORNEY, EXPERT, OR OTHER SERVICES WITHOUT PAYMENT OF FEE

IN THE UNITED STATES

DISTRICT COURT

COURT OF APPEALS

IN THE CASE OF

V.

PERSON REPRESENTED (Show your full name)

CHARGE/OFFENSE (Describe if applicable & check box)

Felony

 

Misdemeanor

 

OTHER (Specify Below)

 

 

 

 

FOR

 

 

 

LOCATION

 

 

 

 

 

NUMBER

 

 

 

 

 

 

 

AT

 

 

 

 

 

 

 

 

 

 

1

Defendant - Adult

 

 

 

 

 

 

DOCKET NUMBERS

 

2

Defendant - Juvenile

Magistrate Judge

 

3

Appellant

 

 

 

 

4

Probation Violator

District Court

 

 

 

 

 

5

Supervised Release Violator

 

 

 

 

6

Habeas Petitioner

Court of Appeals

 

 

 

 

 

7

2255 Petitioner

 

 

 

 

 

 

 

 

8

Material Witness

 

 

 

 

9

Other (Specify) __________________________________

 

 

 

 

 

 

ANSWERS TO QUESTIONS REGARDING ABILITY TO PAY

 

 

 

 

Do you have a job?

Yes No

 

 

 

 

 

EMPLOYMENT

IF YES, how much do you earn per month? _______________________

 

 

 

 

Will you still have a job after this arrest?

Yes

No Unknown

 

 

 

 

 

 

 

 

 

 

Do you own any of the following, and if so, what is it worth?

 

INCOME

 

 

 

 

APPROXIMATEVALUE

DESCRIPTION &AMOUNTOWED

 

 

 

Home

$_____________________

_________________________________

&

 

PROPERTY

Car/Truck/Vehicle$_____________________

_________________________________

ASSETS

 

 

 

Boat

$_____________________

_________________________________

 

 

 

 

 

 

 

 

Stocks/bonds

$_____________________

_________________________________

 

 

 

 

Other property $_____________________

_________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

CASH

Do you have any cash, or money in savings or checking accounts?

Yes No

 

 

&

 

 

 

BANK

IF YES, give the total approximate amount after monthly expenses

$_____________

 

 

ACCOUNTS

 

 

 

 

 

 

 

 

 

 

 

How many people do you financially support? ______

 

 

 

 

 

 

 

BILLS & DEBTS

MONTHLY EXPENSE

TOTAL DEBT

 

 

 

 

Housing

 

$_________________

$_________________

 

 

 

 

Groceries

 

$_________________

$_________________

 

 

 

 

Medical expenses

$_________________

$_________________

OBLIGATIONS,

 

Utilities

 

$_________________

$_________________

 

Credit cards

 

$_________________

$_________________

EXPENSES, &

 

 

DEBTS

 

 

Car/Truck/Vehicle

$_________________

$_________________

 

 

 

 

Childcare

 

$_________________

$_________________

 

 

 

 

Child support

 

$_________________

$_________________

 

 

 

 

Insurance

 

$_________________

$_________________

 

 

 

 

Loans

 

$_________________

$_________________

 

 

 

 

Fines

 

$_________________

$_________________

 

 

 

 

Other

 

$_________________

$_________________

I certify under penalty of perjury that the foregoing is true and correct.

_________________________________________________________

________________

SIGNATURE OF DEFENDANT

Date

(OR PERSON SEEKING REPRESENTATION)

 

Instructions for CJA Form 23 Financial Affidavit

In every type of proceeding where appointment of counsel is authorized under 18 U.S.C. § 3006A(a) and related statutes, the United States magistrate judge or the court shall advise the person of their right to be represented by counsel and that counsel will be appointed if the person is financially unable to obtain counsel. Unless the person waives representation by counsel, the United States magistrate judge or the court, if satisfied after appropriate inquiry that the person is financially unable to obtain counsel, shall appoint counsel to represent the individual.

Determination of eligibility for representation under the CJA is a judicial function, however the court may designate court employees to obtain or verify the facts relevant to the financial eligibility determination. Employees of law enforcement agencies, including the United States Attorney’s Office, should not participate in the completion of the financial affidavit or seek to obtain information concerning financial eligibility from a person requesting the appointment of counsel. When practicable, employees of the federal public defender office should discuss with the person who indicates that he or she is not financially able to secure representation the right to appointed counsel and, if appointment of counsel seems likely, assist in completion of the financial affidavit.

Counsel must be appointed if the person seeking representation is “financially unable to obtain counsel.” 18 U.S.C. §3006A(b). (While courts often use “indigency”

as a shorthand expression to describe financial eligibility, indigency is not the standard for appointing counsel under the Criminal Justice Act.) In determining

whether a person is “financially unable to obtain counsel,” consideration should be

given to the cost of providing the person and his or her dependents with the necessities of life, the cost of securing pretrial release, asset encumbrance, and the likely cost of retained counsel. The initial determination of eligibility must be made

without regard to the financial ability of the person’s family to retain counsel,

unless their family indicates willingness and ability to do so promptly. Any doubts

about a person’s eligibility should be resolved in the person’s favor; erroneous

determinations of eligibility may be corrected at a later time. For additional guidance, see the Guide to Judiciary Policy, Volume 7A, Guidelines for Administering the CJA and Related Statutes (CJA Guidelines).

The CJA Form 23 is not a required statutory form. It is an administrative tool used to assist the court in appointing counsel. When a colorable claim is asserted that disclosure to the government of a completed CJA 23 would be self-incriminating, the

court may not adopt an unconditional requirement that the defendant complete the CJA 23 before his application for appointment of counsel will be considered. To do so may place the defendant in the constitutionally untenable position of having to choose between his Sixth Amendment right to counsel and his Fifth Amendment privilege against self-incrimination. Two approaches that courts have taken to resolve these competing concerns are: (i) through in camera examination of the financial affidavit, which then would be sealed and not be made available for the purpose of prosecution, or (ii) through an adversarial hearing on the defendant's request for appointment of counsel, during which the court would grant use immunity to the defendant’s testimony at the hearing.

Pursuant to Judicial Conference policy, financial affidavits seeking the appointment of counsel should not be included in the public case file and should not be made available to the public at the courthouse or via remote electronic access. If the financial affidavit is docketed it should be filed under seal. See, Guide to Judiciary Policy, Vol. 10, §340, Judicial Conference Policy on Privacy and Public Access to Electronic Case Files (March 2008) and Administrative Office of U.S. Courts Information Bulletin on Revised Judicial Conference Privacy Policy (May 2008).

For questions on the use of this form or instructions, please contact the Defender Services Office, Legal and Policy Division at 202-502-3030.

Form Specifications

Fact Name Description
Purpose The CJA-23 form is used to determine if a person qualifies for court-appointed counsel based on their financial situation.
Eligibility Individuals must provide detailed information about their income, expenses, and assets to assess eligibility.
Confidentiality The information provided in the CJA-23 form is confidential and protected by law.
Governing Law This form is governed by the Criminal Justice Act (CJA) and applicable federal laws.
Submission The completed form must be submitted to the court before a decision is made on appointing counsel.
Updates Any changes in financial circumstances must be reported to the court as soon as possible.
Consequences Providing false information on the form can lead to serious legal consequences, including penalties.

Financial Affidavit CJA-23: Usage Guidelines

Completing the Financial Affidavit CJA-23 form is essential for your case. Ensure that all information is accurate and up-to-date. Follow these steps to fill out the form correctly.

  1. Begin by entering your full name at the top of the form.
  2. Provide your contact information, including your address, phone number, and email address.
  3. Fill in your social security number.
  4. Indicate your marital status by checking the appropriate box.
  5. List all sources of income, including employment, self-employment, government benefits, and any other income streams.
  6. Detail your monthly expenses, such as housing, utilities, food, transportation, and any other necessary costs.
  7. Include information about any assets you own, such as bank accounts, vehicles, real estate, and investments.
  8. Disclose any debts you have, including loans, credit card balances, and other financial obligations.
  9. Sign and date the form at the bottom to certify that the information provided is true and accurate.

After completing the form, review it carefully for any errors or omissions. Make sure to keep a copy for your records before submitting it to the appropriate court or agency.

Your Questions, Answered

What is the CJA-23 Financial Affidavit form?

The CJA-23 Financial Affidavit form is a document used in federal court proceedings to determine a person's financial eligibility for court-appointed counsel under the Criminal Justice Act (CJA). This form collects detailed information about an individual's income, expenses, assets, and liabilities to assess their financial situation.

Who needs to fill out the CJA-23 form?

Individuals who are seeking court-appointed representation because they cannot afford to hire an attorney must complete the CJA-23 form. This includes defendants in criminal cases as well as individuals involved in certain civil matters where the court allows for appointed counsel.

How do I obtain the CJA-23 form?

The CJA-23 form can typically be obtained from the website of the federal court where your case is being heard. Many courts provide downloadable versions of the form. You can also request a physical copy from the clerk’s office at the courthouse.

What information do I need to provide on the CJA-23 form?

You will need to provide comprehensive information regarding your financial status. This includes details about your income (such as wages, benefits, and any other sources), monthly expenses (like rent, utilities, and food), assets (such as bank accounts and property), and any debts or liabilities you may have. Be prepared to provide accurate and honest information, as this will be reviewed by the court.

Can I get help filling out the CJA-23 form?

If you have difficulty completing the CJA-23 form, you can seek assistance from legal aid organizations, public defenders, or court staff. Many courts have resources available to help individuals understand the form and provide guidance on how to fill it out correctly.

What happens after I submit the CJA-23 form?

Once you submit the CJA-23 form, the court will review your financial information to determine your eligibility for court-appointed counsel. You may be required to attend a hearing where a judge will assess your financial situation and decide whether to appoint an attorney to represent you.

How long does it take to get a decision on my eligibility after submitting the CJA-23 form?

The time it takes to receive a decision can vary depending on the court’s schedule and workload. Generally, you can expect a response within a few days to a couple of weeks. If your case is urgent, the court may expedite the review process.

What if my financial situation changes after I submit the CJA-23 form?

If your financial situation changes significantly after you submit the CJA-23 form, it is important to notify the court immediately. Changes in income, expenses, or any other financial circumstances may affect your eligibility for court-appointed counsel.

Is the information I provide on the CJA-23 form confidential?

While the information on the CJA-23 form is generally treated as confidential, it is subject to review by the court and may be disclosed to parties involved in your case. It is crucial to be truthful and accurate, as providing false information can have serious legal consequences.

What should I do if my application for court-appointed counsel is denied?

If your application for court-appointed counsel is denied, you have the right to appeal the decision. You can request a hearing to contest the denial, or you may seek to hire a private attorney if you are able to afford one. It’s advisable to consult with legal aid or a public defender for guidance on the next steps.

Common mistakes

  1. Failing to provide complete information: Many individuals leave sections blank or do not fully explain their financial situation. Each detail matters, so it’s essential to be thorough.

  2. Underreporting income: Some people mistakenly list their income as lower than it actually is. Accurate reporting is crucial for determining eligibility for legal assistance.

  3. Overlooking assets: Individuals often forget to include certain assets, such as real estate, vehicles, or savings accounts. All assets should be disclosed to provide a complete picture.

  4. Not updating the form: Financial situations can change. Failing to update the affidavit after a significant life change, like a job loss or a new job, can lead to inaccuracies.

  5. Misunderstanding expenses: Some applicants miscalculate their monthly expenses or do not account for irregular expenses. It’s important to include all relevant costs to avoid discrepancies.

  6. Ignoring the instructions: Each section of the CJA-23 form comes with specific instructions. Skipping these can lead to errors that might delay processing.

  7. Providing inconsistent information: If the information provided on the CJA-23 conflicts with other documents, it raises red flags. Consistency is key in legal documentation.

  8. Not signing the form: A common oversight is forgetting to sign and date the affidavit. Without a signature, the form is incomplete and cannot be processed.

Documents used along the form

The Financial Affidavit CJA-23 form is an important document used in various legal proceedings, particularly for individuals seeking court-appointed representation. However, it is often accompanied by other forms and documents that help provide a comprehensive picture of an individual’s financial situation. Below is a list of common documents that may be used alongside the CJA-23 form.

  • Income Verification Documents: These may include pay stubs, tax returns, or bank statements that demonstrate an individual’s income. Such documents help establish eligibility for financial assistance.
  • Expense Statement: A detailed account of monthly expenses, including rent, utilities, and other obligations. This statement helps the court understand the financial pressures the individual faces.
  • Asset Declaration: A list of assets owned, such as real estate, vehicles, and savings accounts. This document provides insight into the individual’s overall financial health.
  • Liabilities Statement: A record of outstanding debts, including loans and credit card balances. This helps to illustrate the individual’s financial obligations.
  • Affidavit of Support: If applicable, this document outlines any financial support received from family or friends. It can demonstrate additional resources available to the individual.
  • Court Order for Child Support: If the individual has children, this document may be necessary to show any obligations for child support payments.
  • Proof of Public Assistance: Documentation showing eligibility for government assistance programs, such as food stamps or housing assistance. This can reinforce claims of financial need.
  • Credit Report: A copy of the individual’s credit report can provide a detailed view of their financial history and creditworthiness, which may be relevant in some cases.

Each of these documents plays a crucial role in providing a clear and accurate representation of an individual’s financial situation. Together with the Financial Affidavit CJA-23 form, they help ensure that the court has all the necessary information to make informed decisions regarding legal representation and financial assistance.

Similar forms

The Financial Affidavit CJA-23 form is a key document used in legal proceedings, particularly for individuals seeking court-appointed counsel. It outlines a person's financial situation. Here are seven other documents that are similar to the CJA-23 form, each serving a related purpose in assessing financial status or eligibility for legal assistance:

  • Income Affidavit: This document details a person's income sources and amounts, similar to the CJA-23, which helps determine eligibility for various assistance programs.
  • Affidavit of Support: Used primarily in immigration cases, this form shows that a person has adequate financial support, akin to how the CJA-23 assesses financial capability for legal representation.
  • Financial Disclosure Statement: Often required in family law cases, this statement provides a comprehensive view of an individual's finances, much like the CJA-23 form.
  • Application for Waiver of Fees: This form requests a waiver for court fees based on financial hardship, paralleling the CJA-23's purpose of evaluating financial need.
  • Tax Returns: Personal tax returns serve as a crucial financial document that provides insight into an individual’s earnings, similar to the income details required in the CJA-23.
  • Bank Statements: These documents reflect an individual's financial activity and balance, which can be essential for understanding financial status, just like the CJA-23 form.
  • Debt Affidavit: This form outlines an individual’s debts and liabilities, providing a full picture of financial obligations, much like the comprehensive nature of the CJA-23.

Dos and Don'ts

When filling out the Financial Affidavit CJA-23 form, it's important to approach the task with care. This form plays a critical role in determining eligibility for court-appointed counsel. Here are some key dos and don'ts to keep in mind:

  • Do read the instructions carefully before you begin. Understanding the requirements will help you complete the form accurately.
  • Do provide complete and honest information. Transparency is essential for the court to assess your financial situation.
  • Do double-check your calculations. Errors can lead to delays or complications in your application.
  • Do sign and date the form. An unsigned form may be considered incomplete and could be rejected.
  • Don't rush through the form. Take your time to ensure all sections are filled out correctly.
  • Don't omit any sources of income or assets. Failing to disclose everything can result in legal issues down the line.
  • Don't use vague language. Be specific about your financial situation to avoid misunderstandings.
  • Don't forget to keep a copy of the completed form for your records. This will be useful for future reference.

Misconceptions

The Financial Affidavit CJA-23 form is an important document for individuals seeking court-appointed counsel. However, several misconceptions surround this form. Here are nine common misunderstandings:

  1. Only low-income individuals need to fill out the CJA-23 form. Many people believe that only those with minimal income qualify. In reality, the form is for anyone who cannot afford an attorney, regardless of their income level.
  2. The CJA-23 form is only for criminal cases. While primarily used in criminal cases, the form can also apply in certain civil matters where a defendant needs representation and cannot afford it.
  3. Completing the form guarantees that you will receive a court-appointed attorney. Submitting the CJA-23 does not automatically ensure representation. The court must still review the application and determine eligibility.
  4. Filling out the CJA-23 form is a simple process. Some may think it’s straightforward, but it requires detailed financial information. Incomplete or inaccurate information can lead to delays or denials.
  5. You can submit the CJA-23 form at any time. There are specific timelines for submitting this form, often dictated by court schedules. It’s essential to be aware of these deadlines.
  6. Once the form is submitted, you have no further responsibilities. After submitting the CJA-23, individuals may still need to provide additional documentation or attend hearings regarding their financial status.
  7. The CJA-23 form is only for federal cases. While it is widely used in federal courts, some state courts also utilize similar forms to assess eligibility for public defenders.
  8. All financial information is kept confidential. While the court takes privacy seriously, some financial details may become part of the public record. It’s important to understand what information is disclosed.
  9. There is no assistance available for completing the CJA-23 form. Many legal aid organizations and public defenders can help individuals fill out the form accurately, ensuring all necessary information is included.

Understanding these misconceptions can help individuals navigate the process more effectively and ensure they receive the legal assistance they need.

Key takeaways

When filling out the Financial Affidavit CJA-23 form, it is important to keep several key points in mind. This form is essential for individuals seeking court-appointed counsel based on their financial situation.

  • Accuracy is crucial. Ensure that all information provided is correct and truthful. Any discrepancies can lead to delays or complications in your case.
  • Complete all sections. Take the time to fill out every part of the form. Incomplete submissions may be rejected, requiring you to start over.
  • Document your income. Be prepared to provide proof of your income, such as pay stubs or tax returns. This documentation supports your claims and helps the court assess your financial need.
  • Review your expenses. List all necessary living expenses accurately. This includes rent, utilities, and any other regular payments you make.
  • Seek assistance if needed. If you have questions or feel overwhelmed, consider reaching out for help. Legal aid organizations or community resources can provide guidance in completing the form.

By keeping these points in mind, you can ensure that your Financial Affidavit CJA-23 form is completed properly and submitted on time, which is vital for receiving the support you may need.