Q(1): Is this a civil or criminal matter? A: Civil Q(1.1): Do you receive assistance under Welfare (TSA or SAGA), Food Stamps (SNAP), SSI (Supplemental Security Income), State Supplement (AABD/Aid to the Aged, Blind and Disabled)? A: Yes Q(1.1.1):You are likely to quality as indigent and receive a waiver for your some or all of your court fees. Would you like to apply for a fee waiver? A: Yes Q(1.1.1.1):GOTO:1.1.2.2.1.1 A: No Q(1.1.1.2):GOTO:1.1.2.2.1.2 A: No Q(1.1.2): Is your income fall below the poverty line, especially after taxes and deductions? A: Yes Q(1.1.2.1):GOTO:1.1.1 A: No Q(1.1.2.2): Can you pay the court fees or costs without depriving yourself or those who are dependent on you of the necessities of life, including food, shelter and clothing? A: Yes Q(1.1.2.2.1): You are unlikely to quality as indigent and receive a fee waiver. However, fee waivers are granted on a discretionary basis. Would you like to fill out a State of Connecticut application for waiver of fees? A: Yes Q(1.1.2.2.1.1): Is this a family law matter? A: Yes Q(1.1.2.2.1.1.1): ] A: No Q(1.1.2.2.1.1.2): Is this a general civil, housing, or small claims matter? A: Yes Q(1.1.2.2.1.1.2.1): A:No A: No Q(1.1.2.2.1.2): For more information, please contact your attorney, or a State of Connecticut representative. A: No Q(1.1.2.2.2):GOTO:1.1.1 A: Criminal Q(1.2): Have you been charged with a misdemeanor? A: Yes Q(1.2.1):How many dependents are in your household? A: None Q(1.2.1.1): Do you have an income of $17,505 gross annually? A:Yes Q(1.2.1.1.1): You are likely able to qualify as indigent and receive free legal services. A:No Q(1.2.1.1.2):You are likely unable to qualify as an indigent and receive free legal services. A: One Q(1.2.1.2): Do you have an income of $23,595 gross annually? A: Yes Q(1.2.1.2.1):GOTO:1.2.1.1.1 A: No Q(1.2.1.2.2):GOTO:1.2.1.1.2 A: Two Q(1.2.1.3): Do you have an income of $29,685 gross annually? A: Yes Q(1.2.1.3.1):GOTO:1.2.1.1.1 A: No Q(1.2.1.3.2):GOTO:1.2.1.1.2 A: Three or more Q(1.2.1.4): Do you have an income of $35,775 gross annually? A: Yes Q(1.2.1.4.1):GOTO:1.2.1.1.1 A: No Q(1.2.1.4.2):GOTO:1.2.1.1.2 A: No Q(1.2.2): Have you been charged with a felony? A: Yes Q(1.2.2.1): Are you a youthful offender (under the age of 18)? A: Yes Q(1.2.2.1.1): What kind of household do you reside in? A: Single parent household Q(1.2.2.1.1.1): Is your parents gross annual income $31,460 or less? A: Yes Q(1.2.2.1.1.1.1):GOTO:1.2.1.1.1 A: No Q(1.2.2.1.1.1.2):GOTO:1.2.1.1.2 A: Dual parent household Q(1.2.2.1.1.2): Is your parents gross annual income $39,580 or less? A: Yes Q(1.2.2.1.1.2.1):GOTO:1.2.1.1.1 A: No Q(1.2.2.1.1.2.2):GOTO:1.2.1.1.2 A: No Q(1.2.2.1.2): How many dependents do you have? A: Zero Q(1.2.2.1.2.1): Do you have an income of $23,340 gross annually? A: Yes Q(1.2.2.1.2.1.1):GOTO:1.2.1.1.1 A: No Q(1.2.2.1.2.1.2):GOTO:1.2.1.1.2 A: One Q(1.2.2.1.2.2): Do you have an income of $23,595 gross annually? A: Yes Q(1.2.2.1.2.2.1):GOTO:1.2.1.1.1 A: No Q(1.2.2.1.2.2.2):GOTO:1.2.1.1.2 A: Two Q(1.2.2.1.2.3): Do you have an income of $23,595 gross annually? A: Yes Q(1.2.2.1.2.3.1):GOTO:1.2.1.1.1 A: No Q(1.2.2.1.2.3.2):GOTO:1.2.1.1.2 A: Three or more Q(1.2.2.1.2.4):Do you have an income of $23,595 gross annually? A: Yes Q(1.2.2.1.2.4.1):GOTO:1.2.1.1.1 A: No Q(1.2.2.1.2.4.2):GOTO:1.2.1.1.2 A: No Q(1.2.2.2): Assignment of counsel in Connecticut is granted on a discretionary basis. Would you like to fill out a State of Connecticut application for waiver of fees, costs and expenses and appointment of counsel on appeal? A: Yes Q(1.2.2.2.1): A: No Q(1.2.2.2.2): For more information, please contact an attorney, the Connecticut Division of Public Defender Services, or a State of Connecticut representative.