Del. R. Sup. Ct. Form 57.1-1
(CASE CAPTION)
I, [name], am a [plaintiff/defendant] in the above-entitled summary-possession matter in the Justice of the Peace Court. [Name of Supervising Agency] has arranged for me to be represented in this matter by [name of Qualified Tenant Advocate], under the supervision of [name of Supervising Attorney], an attorney admitted to practice law in the State of Delaware. I have been given a copy of Rule 57.1 of the Supreme Court of the State of Delaware. I understand that [Name of Qualified Tenant Advocate] is not an attorney but is authorized to provide representation to tenants in summary-possession actions in the Justice of the Peace Court under the supervision of a Delaware attorney. I consent to representation by [Name of Qualified Tenant Advocate], and I voluntarily and knowingly waive any right I may have to representation by a member of the Delaware Bar.
Dated: ______________________ _________________________
[Tenant]
STATE OF DELAWARE
COUNTY OF _____________________
Sworn to (or affirmed) and subscribed before me this _________day of _____________ 20__.
_______________
(Duly authorized official)
I agree to provide the representation described above in accordance with Rule 57.1.
_______________
[Qualified Tenant Advocate]
I will supervise [Name of Qualified Tenant Advocate] in accordance with Rule 57.1, and I hereby assume personal professional responsibility for the Qualified Tenant Advocate's guidance in any work undertaken, and for supervising the quality of the Qualified Tenant Advocate's work.
_______________
[Supervising Attorney]
Del. R. Sup. Ct. Form 57.1-1