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HomeMy WebLinkAbout12-08-09AUTHORITY TO PAY COURT APPOINTED COUNSEL SEC 0 ~. 2009 ~ ;~ 1. COURT O Di i t t J i ;?. VOUCHER r s c ust ce Common Pleas ~ Appellate l7 Other N~ 13 5 9 6 3. FOR (D.J., C.P., APPELLATE) 4. AT (CITY/STATE) _ `i. BUDGET CODE ~~ l~e._. - s'aio -- ~av 6. IN THE CASE OF (~ ( T. C HARGEIOFFENSE (PURDON CITATION) fl. O PETTY OFFENSE ~ ,~,~.~ M ~, L-~~ g • ~~t,.Y'r;'Q!~ ~1"l~V r ~ t ~\l~ CQ ~'L (7 FELONY O MISDEMEANOR 9. PROCEEDINGS (Describe briefly) 1 1. PERSON REPRESENTED 12. CIVIL DOCKET NO. /^ ~~ ~/'~ ' / P`-`"'`"" ~ r t O Defendant -Adult 2 O Defendant • Juvenile r ~~ ~ (' ~ •~~ 3~ 3 O Appellant 4 ^ Appellee 13. CRIMINAL DOCKET NO. 5 O Habeas Petitioner 6 ^ Material Witness 10. PERSON REPRESENTED (Full Name) 7 O Parolee Charged With Violation g ^ Probationer Charged with Violation - 14 APPEALS DOCKET NO. ~~~' ~~~ 9 ^ Other. 16. NAME OF ATTORNEY/PAYEE AND Q~ ^) Appt Date ~ MAILING ADDRESS ~~ ( v ~ NAME OF COM ON PLEAS JUDGE ASSIGNED TO CASE i? ~~/\.`• ~-j ~~^ ~~~ ~ 17. TELEPHONE No. 18. s ~ciA~ sECURITV No oA I"city No O r:L-~, ~ ~I O CLAIM FOR SERVICES OR EXPENSES 19. SERVICE HOURS DATES AMOUNTS CLAIMED a. Arraignment and/or Plea _ Mulriply rate per hour times total b. Preliminary Hearing hcu~s to obtain "In Court" com- pentation Er t t l b l r~ Motions and Requests . b o a e ow. ~ ",..~ ~ d. Bail Hearings. *~ ,.;1.', ~::"^^°~~s ~~ ~~ ~ e. Sentence Hearings ~ . J ~ © 6 3 '=~~ I"rt9 ~ , ") :., .'~ ' v ...I _~ C 7 t ~ ;. ~ Z f. Trial . , _ ,"~ ~',"~~* f~t"I ! I' ~ti. ; ~.~i;:a g. Revocation Hearings ~~~" ~~:~, ~ fD4 =t7 r'""~ h. Juvenile Hearings .. C "t. ~ ~ f ,.. ~"' ~,..'r J i. Appeals Court DOTAL 1 OUR~';~Q~p. j. Other (Specify on additional sheets) ~il N ~~ i - O TOTAL HOURS = X $55 PER HOUR ~~ • $ 'r 20. a. Interviews and conferences Mwl*ipty rate per hour times total ~ b. Obtaining and reviewing records hours. Enter total "Out of Court" m ti b ~ ¢ c. legal research and brief writing pensa co on elow. O' O d. Investigative and other work (Specify on additional sheets) 20A. TOTAL OUT OF COURT COMP. TOTAL HOURS = /3~ ~ X $45 PER HOUR ~ $ ~ ~ `~ O~ 2t• ITEMIZATION OF REIMBURSABLE EXP ENSES AMT. PER ITEM Milage per mile x (o w t ~ O ~ U ~- ro 21A. 'TOTAL ITEMIZED EXP. ~Q' = S v t•1 • 22. CERTIFICATION OF ATTORNEY/PAYEE 23. GRAND TOTAL CLAIMED Has compensation and/or reimbursement for work in this case proviously been applied fort ^ YES ~] NO s S ' II yes, were you paid? ^ YES ONO If yes by whom were you paid? How 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 representati ? OYES O es. ive,d etails on add l `ryal sheet a S C- ~v I swear or affirm the truth or correctness - l / of the above statements 25: NF_T AMOUNT C IMED ignaturs of A may/Pays Oate ~f S 3p~~ i 2Cj!1NPgOVEU i Fuu Sgnature of ~ ~~rruENr Judge ~ ~~ ~ C--1 ~ Dat C 27. AMT. APPROVED ~ . e: CG , L ~OC~ l ~ , = S %~ Co~Sy 1 -Mail to Court Administrator at completion of service