HomeMy WebLinkAbout06-08-09AUTHORITY TO PAY COURT APPOINTED COUNSEL ~ MAY 2 9 2009 p~'`
1. COURT
^ District Justice ',Common Pleas ^ Appellate ^ Other 2. VOUCHER
N~ 13 3 9 5
3. FOR (D.J., C.P., APPELLATE) 4. AT (CITY/STATE) 5. BUDGET CODE
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6. IN THE CASE OF 7. CHARGE/OFFENSE (PUROON CITATION) 8. ^ PETTY OFFENSE
vs O FELONY ^ MISDEMEANOR
9. PROCEEDINGS (Describe brielly~
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~r~'~ 11. PERSON REPRESENTED
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D 12. CIVIL DOCKET NO.
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endant-Adult
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_ ` , Qn 2 O endant ~ Juven
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(~ 3 O Appellant
a ^ Appellee 13. CRIMINAL DOCKET NO.
5 ^ Habeas Petitioner
6 ^ Material Wdness
10. PERSON REP~IRESENTED (Full Name) ` ^
~ ~ L "T ~'~ ~ . C~lr C~l'~l (S l'~ ~ 7 ^ Parolee Charged With Violation
a ^ ProbationerCharged With Violation
9 ~GOtner /Ar ~ ~.[.G eC~
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14. APPEALS DOCKET NO.
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16. NAME OF ATTORNEY/PAYEE AND
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Appt Oate ,-,~„~y_ ~~ MAILING ADDRESS ~
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NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE
17. TELEPHONE No. 18. soclnLSecualrvNO O EINNO
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CLAIM FOR SERVICES OR EXPENSES ~ 4°.,
19. SERVICE HOUP.S DATES AMOU S CL ~x3--
a. Arraignment and/or Plee t rate hour al
b. Preliminary Hearing obtln CduiP 4•
n. Enter total ttgl~r ~y:-t
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a Motions and Requests w
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~ d 8ai1 Hearings [-~[, •~ C}-~~ ~ _-~y
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O e. Sentence Hearings ~j ~ --'~
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Z I. Trial r'T7
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g. Revocation Hearings ~- ~ ^
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h. Juvenile Hearings N
i. Appeals Court 190. TOTAL IN COURT COMP.
j. Other (Specify on additional sheets) t ~~ ~ ~ `. ~, '~(~
- $ ~~~ ~ ~ (/
TOTAL HOURS = X $55 PER HOUR
20. a. Interviews and conferences ~, Multiply rate per hour times total
(i ~ b. Obtaining and roviewing records
hours. Enter total "Out of Court"
compensation below.
O ? c Legal research and brief wrltinq
~ ~ d. investigative and other work (Specify on additional sheets) 200. TOTAL OUT OF COURT
COMP.
3 $ t ~
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TOTAL HOURS = ~• y X $45 PER HOUR "
21. ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM `~ 9
Milage $ per mile x •
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W -T3 r -] OLD
210. TOTAL ITEMf2ED EXP.
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22. CERTIFICATION OF ATTORNEY/PAYEE 23. GRAND TOTAL CLAIMED
Has compensation and/or reimbursement for work in this case proviously been applied fort ^ YES ~iNO = s ~f,
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id? ^ YES ^ NO
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yes, were you pa
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yes, bywhom were you paid? ow much
Has the person represented paid any money to you, or to your knowledge anyone else, in connection with the matter for 24. DEDUCT. PRIOR PYMTS.
which you were appointed to provide represent o ? ^ YES NO yes,
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give details on additional sheets S
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I swear or alfirm the truth or cortectness .
~~ ~ 25: NET AMOUNT CLAIMED
of the above statements Signature of Atto /Payee Date
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26.n,•onuv(o j ~
FUU $ignatufe Of / ~ 27. AMT. APPROVED
~wtaENr Judge ~ _~ ~Dats: v "~)C Z LU;~ = S
,) Ct~iy 1 -Mail to ~ourt Administrator at completion of service
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