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HomeMy WebLinkAbout12-08-09 (2)AUTHORITY TO PAY COURT APPOINTED COUNSEL /~' ~?~'~ ~ ~. X009 t. COURT i i J O ?. VOUCHER N~ 13 5 9 6 str ct D ustice Common Pleas ^ Appellate ^ Other 3. FOR (D.J., C.P., APPELLATE) 4. AT (CITY/STATE) !i. BUDGET CODE l~._, _~ - saro -- a~av 6. IN THE CASE OF Mn . ~ ~ 7. CHARGE/OFFENSE (PURDON CITATION) 1 li. ^ PETTY OFFENSE (7 FELONY CJ MISDEMEANOR L~~ ~ ~~ ~,~~ ~ 1~ ~ J • ~ - ~ ~~ Ca C` 9. PROCEEDIN Describe briefly) G S ( 1 t. PERSON REPRESENTED t 2. CIVIL DOCKET NO. C /~ ~P~ ~ ~ t O Defendant -Adult f il r ~~ ~ ' ~ ~ endant • Juven e 2 O De 1 ~" 3 O Appellant t:{. CRIMINAL DOCKET NO. a O Appellee 5 O Habeas Petitioner 6 ^ Material Witness i ti Wi l P - 10. PERSON REPRESENTED (Full Name) on arolee Charged th V o a 7 O e ^ Probationer Charged With Violation t 4. APPEALS DOCKET NO. f ~~'`~ ~'~i ~ ~ ~~1~~ -~~r V 9 O Other. 16. NAME OF ATTORNEY/PAYEE ANCI ^ ~ ©~ { SS Appt Oate MAILING ADDRE ('~ ~QV C C G LJ,r '' I V _ \ ~ i~~ ~V ~ ~ NAME OF COM ON PLEAS JUDGE ASSIGNED TO CASE ~~~t.J~,` --j EPHONE No. 1 B-"iOCIAL SECURITY NO OR EIN NO t 7. TE L [ ~ 4 ~v ~ ~ O ~' ~ ~~ O CLAIM FOR SERVICES OR EXPENSES t9. SERVICE HOUP.S DATES AMOUNTS CLAIMED a. Arraignment and/or Plea Multiply rate per hour times total " " b. Preliminary Hearing hours to obtain com- In Court pensation. Erb total below. c Motions and Requests ~ -~,-7 ~ d Bail Hearings ~ ~7 © `-. 3-` ,~ ,> ~ e. Sentence Hearings ~ ~~~ ~ ~ ' ~ U f. Trial .7 ~=;= f~T'1 ! t.°~_ ~'-r y g. Revocation Hearings ~~ ~;.~~ ~ h. Juvenile Hearings '[~7 ~ ~ `r`'i i. Appeals Couri ,E.?OTAL I OUR ~~• j. Other (Specify on additional sheets) .,~ -~-d ~ ~~,7 ! TOTAL HOURS ~ X $55 PER HOUR - $ '~ 20. a. Interviews and conferences Multiply rate per hour times total b. Obtaining and reviewing records hours. Enter total "Out of Court" compensation below. ~ ¢ H ~ c. Legal research and brief writing ~ ' L. ~ 4 d. Investigative and other work (Specify on additional sheets) 20A. TOTAL OUT OF COURT COMP. TOTAL HOURS = /3, ~ X $45 PER HOUR 3 $ ~ ~ ~ ~ O 2t. ITEMIZATION OF REIMBURSABLE EX PENSES AMT. PER ITEM Milage per mile x (o f,L W ~ O ~Q U `j. (0 P. 21 A. TOTAL ITEMIZED E X / ~ ~S ~( a S ~ ~ 22. CERTIFICATION OF ATTORNEY/PAYEE 23. GRAND TOTAL CLAIMED Has compensation and/or reimbursement for work in this case proviousy been applied forT OYES n6] NO = S . If yes, were you paid? ^ YES ONO Ityes, by whom were you paid? How much? y y y y dge anyone else, in connection with the matter for Has the person represented paid an move to ou. or to our knowle 24. DEDUCT. PRIOR PYMTS. which you were appointed to provide representatl ? OYES O es. iv details on additio I sheetf a S I swear or affirm the truth or correctness - t `V t,~~~ I ~~ 25: NET AMOUNT C IMED of the above statements Ignaturs of A may/Pays Date = s ~~~ ~~ 26.~c~o{auvE a FtJ{{ r'AVMEN{ ~ / r j Signature of rM1 /f ~ Jud e - ~ D ~ c 27. AMT. APPROVED a ~- g ...; - ate: ~.~; ~ Z Z~n 1 Z v~~ Coy 1 -Mail to Court Administrator at completion of service