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dated where locally emboli red). abscssisaustsassitc.Mostassmicedistss (Poem Defender Application Fee) pursuant to Sections 27.51(2)(a) and 938 29. Honda Stabiles (s 540.00 fee shall be imposed if nor previously collected of waived). Strike oat If previously paid or represented by private ounsel (Pab
t O Deft sign O Def Co O Prob O Jail O DJJ O GAL Notified by mail by: O County Courthouse O Courtroom, Criminal Justice Bldg. O Courtroom, Criminal Justice Complex 205 N. Dixie, West Palm Beach 38844 State Road 80, Belle Glade 3228 Gun Club Rd., West Palm Beach Div P. in at AM/PM Div Ftm_ at AM/PM O
of the Defendant. the financial needs and ability of the Defendant, and other Odors which this Cowl has deemed appropriate, a sum pursuant to 93827, Honda Statutes (may be imposed where agency entitled to costs of prosecution requests and documents specific cost.). 21. S (State Agency Law Enforeemee
SA 0 Bondsman O Prob 0 Jail 0 DU Cl GAL Notified by mail by: on / / O County Courthouse 0 Courtroom, Criminal Justice Bldg. 0 Courtroom, Criminal Justice Complex 205 N. Dixie, West Palm Beach 38844 State Road 80, Belle Glade 3228 Gun Club Rd., West Palm Beach W YOU AM A PERSON WWH A DISABILITY WHO FEEDS MN
collected or waived) Strike oat If previously paid or represented by private tuned. (Public Defender's Fees and Costs) pursuant to Section 938.29. Honda Statutes and Fla. R. Crim. P. 3.72MdX I ) and Local Administrative Order. (Minimum fee of 5150.00 is statutorily mandated following notice of Imposi
eset 0 Deft sign O Def Co O Prob O Jail O DO 0 GAL Notified by mail by: O County Courthouse O Courtroom, Criminal Justice Bldg. O Courtroom, Criminal Justice Complex 205 N. Dixie, West Palm Beach 38844 State Road 80, Belle Glade 3228 Gun Club Rd., West Palm Beach Div Rm _ at AM/PM O ASA O Bondsman on F
right to the assistance of counsel in taking said appeal at the expense of the State upon showing of indigency. Din Open Court Palm Beach County. Honda. this E AND ORDER 3 r day ofittilt...9 . 200 VP11 ~tr. In Mt IfIrr II I nirter EFTA00182138 0 Page 2 NAME: DATE A l 0 ' -'7RM OF Prob
nty Courthouse 205 N. Dixie, West Palm Beach O Courtroom, Criminal Justice Bldg. 38844 State Road 80, Belle Glade Cl Bondsman on Cl Courtroom, Criminal Justice Complex 3228 Gun Club Rd.. West Palm Beach 0, YOU ARE AMMON YAM A DISAINUTY WHO FEEOS ANY ACOMMOCIATION N PRYER 1OPARICFNIE N PROCEEDING YOU ARE ENTMEIL A
nt0017 mandated). Wiliam! Just Education by Slunitipalida and Coandei)peasant to Section 933.15. Florida St:~ to be paid to: I I Palm Bach County, Honda (statutorily mandated wine lorally audtorizod). I I the Cityeliimnd'illage of , , Florida (Steamily raandated where locally authorized). (Add
nty Courthouse 205 N. Dixie, West Palm Beach O Courtroom, Criminal Justice Bldg. 38844 State Road 80, Belle Glade Cl Bondsman on Cl Courtroom, Criminal Justice Complex 3228 Gun Club Rd.. West Palm Beach IF YOU APE AMMON YEN A DEASLITY WHO FEEDS ANY ACCOMMOCIATION N MOTO PARICIPATE N THS FROCE0)114 YOU ARE BATHER A
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