Indigency Screening Form

This form asks for detailed personal and financial information to help the court decide if a person can afford to pay for their own defense in a criminal case. It asks about income, assets, and expenses.

Common questions

Who fills out this form?

The form asks for information from the person filling it out, and the court uses it to make a decision. The form also has sections for court use only.

Does filling this out cost money?

The form itself does not mention a filing fee, but the court uses the information to determine if the person is eligible for a public defender at no expense.

What happens after I sign it?

By signing, the person agrees that the information given is true and correct under Washington State law. They also agree to report any changes in their financial status to the court.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2013.

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