COUNTY OF HUNTINGDON OFFICE OF COURT-APPOINTED COUNSEL Huntingdon County Courthouse Frederick R. Gutshall, Esquire 223 Penn Street Director of Court-Appointed Counsel Huntingdon, PA 16652 Phone: (814) 506-9026 Fax: (814) 506-9027 APPLICATION FOR PUBLIC DEFENDER All applications for representation submitted to the Public Defender’s Office will require documentation of all household earned or unearned income. TYPE OF INCOME: Pay Wages Employer Letter (Company Letterhead) Unemployment Compensation Statement from Domestic Relations Child Support Letter from Social Security Social Security Copy of Bank Stmnt showing Direct Dep. SSI Disability Statement from Dept. of Public Welfare Welfare Benefits Retirement/Annuity Disbursement Letter Retirement/Annuities ACCEPTABLE DOCUMENTATION: APPLICATIONS SUBMITTED WITHOUT DOCUMENTATION WILL NOT BE CONSIDERED UNTIL DOCUMENTATION IS PROVIDED (UNLESS YOU ARE PRESENTLY INCARCERATED). PLEASE PRINT NEATLY IF WE CANNOT READ YOUR INFORMATION YOU MAY BE REJECTED
COUNTY OF HUNTINGDON OFFICE OF COURT-APPOINTED COUNSEL Huntingdon County Courthouse Frederick R. Gutshall, Esquire 223 Penn Street Director of Court-Appointed Counsel Huntingdon, PA 16652 Phone: (814) 506-9026 Fax: (814) 506-9027 APPLICATION FOR PUBLIC DEFENDER All applications for representation submitted to the Public Defender’s Office will require documentation of all household earned or unearned income. TYPE OF INCOME: Wages Unemployment Compensation Child Support Social Security SSI Disability Welfare Benefits Retirement/Annuities ACCEPTABLE DOCUMENTATION: Pay Employer Letter (Company Letterhead) Statement from Domestic Relations Letter from Social Security Copy of Bank Stmnt showing Direct Dep. Statement from Dept. of Public Welfare Retirement/Annuity Disbursement Letter APPLICATIONS SUBMITTED WITHOUT DOCUMENTATION WILL NOT BE CONSIDERED UNTIL DOCUMENTATION IS PROVIDED (UNLESS YOU ARE PRESENTLY INCARCERATED). PLEASE PRINT NEATLY IF WE CANNOT READ YOUR INFORMATION YOU MAY BE REJECTED
PD_Application_2018.docx