The Municipal Court

for the City of (City)

(Address)

(City), Wyoming (Zip)

(307) (Telephone # )

Fax (307) (Fax Telephone #)

(Judge's Name)	(Judge's Name)

Senior Municipal Judge	Municipal Judge

CITY OF (City),	)

Plaintiff,	)

)

VS.	)	DOCKET _____________________

)

_______________________,	)

Defendant.	)

ORDER APPOINTING COUNSEL

UPON PROPER REQUEST of the Defendant above named for appointment of counsel herein:

IT IS THEREFORE, HEREBY ORDERED that ________________, the Public Defender for the City of (City), Wyoming, is hereby appointed to represent the above named defendant in the above entitled matter.

FURTHER, that this appointment is subject to a later determination as to indigence, and, if indigence is not shown, this order shall become vacated and deemed of no force and effect.

FURTHER, notice is hereby given that the address of the Defendant is _____________________________and the phone number of the Defendant ______________.

________________________________________
JUDGE

On the _______day of ____________________, 20______, a copy of this notice was sent to:

(Attorney's Name)

(Address)

(City), WY (Zip) the Public Defender for the City of (City) in the above named case.