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UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI

, Plaintiff,

vs. , Defendant(s).

) ) ) ) ) ) ) ) ) )

Case No.

MOTION FOR APPOINTMENT OF COUNSEL AND AFFIDAVIT IN SUPPORT

I, , hereby apply for appointment of Counsel. In support of my application I declare under penalty of perjury that the following facts are true:

(1) I am the plaintiff in the above-entitled case and I believe I am entitled to redress. (2) Because of my poverty I am unable to pay a reasonable attorney fee. (3) I have made diligent efforts to obtain legal counsel but because of my poverty I have been unable to secure same.

I declare under penalty of perjury that the foregoing is true and correct. Executed on , 20 .

Signature of Plaintiff