I may be subject to criminal penalties for making any false statements in this declaration. I authorize the government agency that is responsible for providing lawyers to people who cannot pay in criminal cases to contact me or request information from me or a third party to verify whether I can afford a private lawyer. I may be ordered to pay the cost of my court appointed lawyer if the court later determines that I am able to pay. I declare under criminal penalty under the law of Utah that everything stated in this document is true.