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(1) Except as provided in Subsection (5), on or after January 1, 2022, an individual, who is seeking appointment of an indigent defense service provider, shall submit an affidavit of indigency described in Subsection (2) to the court.
(2) An affidavit of indigency shall include the following information:
(a) the individual's identifying information, including:
(i) the individual's legal name and any known aliases;
(ii) the individual's mobile or residential phone number;
(iii) the individual's residential address; and
(iv) the individual's date of birth; and
(b) the individual's financial information, including:
(i) any financial support or benefit that the individual receives from a state or federal government;
(ii) the individual's monthly income, including any alimony or child support that contributes to the individual's monthly income;
(iii) the individual's monthly expenses, including any alimony or child support obligation that the individual is responsible for paying;
(iv) the individual's ownership of, or any interest in, personal or real property, including any savings or checking accounts or cash;
(v) the number, ages, and relationships of any dependents; and
(vi) any extraordinary financial conditions that would prevent the individual from retaining private counsel.
(3) The affidavit of indigency shall:
(a) require the signature of the individual; and
(b) include a statement that:
(i) by signing the affidavit the individual confirms that, to the best of the individual's knowledge, the information in the affidavit is true;
(ii) the individual may be subject to a criminal penalty for a written false statement under Section 76-8-504;
(iii) the individual authorizes an indigent defense system to contact or request information from the individual or a third party to verify whether an individual is indigent; and
(iv) the individual may be ordered to pay the cost of the individual's indigent defense services if a court determines that the individual is not indigent.
(4) The Judicial Council or Supreme Court shall adopt an affidavit of indigency form described in Subsection (2) to be distributed to an individual seeking the appointment of an indigent defense service provider.
(5) This section does not apply to a minor, who is appointed an indigent defense service provider, or the minor's parent or legal guardian.