By clicking SUBMIT, I certify and affirm that I have read the above or had it read to me; I fully understand the information contained herein, and it is true and correct to the best of my knowledge. I request that this information be considered in determining my eligibility to receive free legal services from the Hendricks County Pro Bono Program. I hereby authorize the Hendricks County Pro Bono Program to release records and information pertaining to my case to the pro bono attorney(s).