Pa. Code tit. 204, pt. II, ch. 29, subch. B, app B
IN THE MATTER OF | : | IN THE COURT OF COMMON | |
PLEAS OF | |||
________________________ | : | COUNTY, PENNSYLVANIA | |
(name) | ORPHANS' COURT DIVISION | ||
An Alleged Incompetent | : | No. | 19____ |
APPLICATION FOR APPOINTMENT
OF COUNSEL FOR ALLEGED INCOMPETENT
_______________________________________________ asserts that the named alleged incompetent is without funds to secure private counsel to represent him/her in the above matter, and that alternative counsel provided by a publicly funded community legal services organization, or like agency providing legal representation to indigents, is also unavailable. The attached affidavit accurately sets forth available assets in support of said application.
____________________________________________________________
The Court Administrator is hereby requested to designate appointed counsel for said alleged incompetent upon the Court's finding of the unavailability of appropriate private counsel as set forth in said application.
BY THE COURT:
____________________________________________________________
DATE:__________________
Pa. Code tit. 204, pt. II, ch. 29, subch. B, app B