Search Warrant Affidavit - United States v. Maurice Fayne related docket

Record facts

U.S. District Court for the Northern District of Georgia · No. 1:20-cr-00228-MHC-JKL · Doc. 4-4 · 2020-07-16 · Docket on CourtListener

Summary

Doc. 4-4 in United States v. Maurice Fayne, No. 1:20-cr-00228-MHC-JKL, in the U.S. District Court for the Northern District of Georgia, filed July 16, 2020, is a one-page financial affidavit in support of a request for attorney, expert or other services without payment of fee, on form CJA 23. The form is completed for Daniel Eric Jay in United States v. Daniel Eric Jay, No. 20-mj-1470, in the Western District of Pennsylvania at Pittsburgh. It answers the form's questions on employment, other income, cash, property, dependents and monthly bills, listing the defendant as previously self-employed. It is dated 07/15/2020 and carries an /s/ signature entered on behalf of Mr. Jay under the form's penalty-of-perjury certification.

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Full text

CJA 23
(Rev. 11/11)
FINANCIAL AFFIDAVIT
IN SUPPORT OF REQUEST FOR ATTORNEY, EXPERT, OR OTHER SERVICES WITHOUT PAYMENT OF FEE
        IN THE UNITED STATES u DISTRICT COURT
u COURT OF APPEALS
u OTHER (Specify below)
IN THE CASE OF
LOCATION NUMBER
FOR
v.
AT
PERSON REPRESENTED (Show your full name)
1 u Defendant - Adult
DOCKET NUMBERS
2 u Defendant - Juvenile
Magistrate Judge
3 u Appellant
4 u Probation Violator
District Court
5 u Supervised Release Violator
5 u Habeas Petitioner
Court of Appeals
CHARGE/OFFENSE (describe if applicable & check boxâ)
u Felony
7 u 2255 Petitioner
u Misdemeanor
8 u Material Witness
9 u Other (Specify)
ANSWERS TO QUESTIONS REGARDING ABILITY TO PAY
INCOME
&
ASSETS
EMPLOY-
MENT
Are you now employed?
u Yes
u No
u Self-Employed
Name and address of employer:
IF YES, how much do you
earn per month?  $
IF NO, give month and year of last employment?
 How much did you earn per month?  $
If married, is your spouse employed?
u Yes
u No
IF YES, how much does your
spouse earn per month?  $
If you are a minor under age 21,
what is the approximate monthly income 
of your parent(s) or guardian(s)?  $
OTHER
INCOME
Have you received within the past 12 months any income from a business, profession or other form of self-employment, or in the 
form of rent payments, interest, dividends, retirement or annuity payments, or other sources?
u Yes
u No
RECEIVED
SOURCES
IF YES, give the amount
received and identify the
sources
$
$
$
CASH
Do you have any cash on hand or money in savings or checking accounts? u Yes u No
IF YES, total amount?  $
PROP-
ERTY
Do you own any real estate, stocks, bonds, notes, automobiles, or other valuable property (excluding ordinary household furnishings
and clothing)? u Yes u
No
VALUE
DESCRIPTION
IF YES, give value and
description for each
$
$
$
$
OBLIGATIONS
&
DEBTS
DEPENDENTS
MARITAL STATUS
Total
No. of
Dependents
List persons you actually support and your relationship to them
Single
Married
Widowed
Separated or Divorced
DEBTS &
MONTHLY BILLS
(Rent, utilities, loans,
charge accounts, etc.)
DESCRIPTION
TOTAL DEBT
MONTHLY
PAYMENT
$
$
$
$
$
$
$
$
I certify under penalty of perjury that the foregoing is true and correct.  
SIGNATURE OF DEFENDANT
(OR PERSON REPRESENTED)
Date
$SSURYHG
'HQLHG
%\WKH&RXUWBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
'DWHBBBBBBBBBBBBBBBBBBBBBBBBBBBB
✔
UNITED STATES
Western District of Pennsylvania
Pittsburgh, Pennsylvania
Daniel Eric Jay
✔
✔
Self-employed (previous, currently receiving $0/month) - see below for earnings
04/2020
0.00
✔
30,000.00
Self-employment - total last year
✔
-188.00
✔
Self
1
✔
Cell phone
250.00
Car
1,500.00
Short-term rental
1,900.00
/s/ Sarah Levin on behalf of Daniel Eric Jay
07/15/2020
20-mj-1470
JAY
7/15/2020
Case 1:20-cr-00228-MHC-JKL     Document 4-4     Filed 07/16/20     Page 1 of 1

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