USA Statement of Parolee or Releasee Concerning Appointment of Counsel

Prepare a Statement of a parolee or mandatory releasee concerning the appointment of counsel under the Criminal Justice Act with this free US Federal Court form.

• This is a downloadable PDF form which can be completed on your computer and printed.
• The parolee or releasee can specify whether or not he/she wants to apply to the court for appointment of counsel. If so, he/she must provide financial information to support the application.

USA Statement of Parolee or Mandatory Releasee Concerning Appointment of Counsel under the Criminal Justice Act, United States District Court Form CJA 22 (9/76).