HomeMy WebLinkAbout08-19-09- _ __ _
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AUTHORITY TO PAY COURT APPOINTED COUNSEL
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t. COURT 2. VOUCHER
^ District Justice ®Common Pleas ^ Appellate ^ Other No
3. FOR ID.J., C.P., APPEL ATE) 4. T C STATE 5. BUDGET CODE
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6. TH CA E OF 7. CHARGE/OFFENSE ( RDON CITATION) 8. ^ PETTY OFFENSE
O FELONY ^ MISDEMEANOR
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9. PROCEEDINGS (Describe briefly) 11. PERSON REPRESENTED i2. CIVIL DOCKET NO.
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~ 1 ^ Defendant-Adult
2 ^ Delendant~Juvenila
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~ 3 ^ Appellant
4 ^ Appellee 13. CRIMINAL DOCKET NO.
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~ 5 ^ Habeas Petitioner ~ n
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10. PERSON REPRE ENT (Full Name) 7 O Parolee Charged With Violation
e ^ probationer Charged With Violation 14. APPEALS DOCKET NO.
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~ 16. NAME OF ATT RNEY/PAYEE A ND
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Appl Date J MAILI
NG ADDRESS /~
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AME O COMMO PLEA
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SIG O CASE W' •
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17. TELEPHONE o soon S RITY OREIN
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CLAIM FOR SERVICES OR EXPENSES
1 g. SERVICE HOUP.S DATES AMOUNTS CLAIMED
a. Arraignment and/or Plea Multiply rate per hour times total
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b. Prelimine Heari
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In Court
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pensation. Entgr;ytal below.
c Motions and ReCuests C ~ ~
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d Bail Hearings ~ ~
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? f. Trial .
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g. Revocation Hearings - ~,r; ~ tlJ - t
h. Juvenile Hearings _- j%'~ c ~' ya ~
i. Appeals Court OTAL 1 OURT~OMP.
i. Other (Specify on additional sheets) _~
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TOTAL HOURS = X $55 PER HOUR _ $
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20. a. Interviews and conferences Multiply rate per hour times total
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b. Obtaining and reviewing records hours. Enter total
Out of Court
compensation below.
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~7 c Legal research and brief writing
0 ~ d. Invesdgative and other work (Specify on additional sheets) 200. TOTAL OUT OF COURT
COMP.
TOTAL HOURS = X $45 PER HOUR $
2t. ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM
Milage $.48 per mile x
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~ 210. TOTAL ITEMIZED EXP.
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22. CERTIFICATION OF ATTORNEY/PAYEE 23. GRAND TOTAL CLAIMED
Has compensation and/or reimbursement for work in this case provioualy been applied toll ^ YES ^ NO = S /~~'
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If yes, were you paid? ^ YES ^ NO If yes, by whom were you paid? How much?
Has the person represented paid any mono o yo or to your knowle an one else, in connection wi the after for 24. DEDUCT. PRIOR PYMTS.
which you were appointed to provide repre ntation ES N ye give details o i on I h a s
I swear or alfirm the truth or correctness 25: NET AMOUNT CLAIMED
of the above statements not eY yea Oa e = s 2
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cui+ Signature of
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Copy 1 -Mail to Court Administrator at completion of service