HomeMy WebLinkAbout04-16-10„~ APR 12 2010
AUTHORITY TO PAY COURT APPOINTED COUNSEL
t. COURT
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^ District Justice ~ Common Pleas ^ Appellate ^ Other A
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3. FOR (D.J . C.P., APPELLATE) 4. T (CITY/ TATt7 5. BUDGET CODE
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6. IN T EA OF / ~
L 7. CHARGE/OFFENSE (PURDON CITATION) 8. ^ PETTY OFFENSE
^ FELONY O MISDE
MEANOR
9. PROCEEDING (Describe briefly) t t. PERSON REPRESENTED 12. CIVIL DO&1~1~ N0
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1 ^ Delandant • Adult
2 ^ Delendant ~ Juvenile ~
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hf" 3 ^ Appellant
4 ^ APPellee 13. CRIMINAL DOCKET NO.
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J ,Y/Ill/' S ^ Mabees Peuhoner
8 O Material W,tness
10. PERSON REPRESENTED (Full Name) ~ 7 ^ Psrolse Cnargsd With Violation
e O Probationer Cnargao Witn Violation
14. APPEALS DOCKET NO.
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Appt Data
iJ 16. NAME OF ATTORNEY/PAYEE AND ~/^A~~
MAILING ADDRESS
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NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE I ~ ~ ~ ~c~'-' y `~7 r~~
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17. LEPHQDIE t8. s t SE ualirNO FIN
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CLAIM FOR SERVICES OR EXPENSES
19. SERVICE HOURS GATES AMOU CLAIMED
a. Arraignment and/or Plsa
b
Pr
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N Itiply rate our times fg~l
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a Motlona and Rer7uasts .
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d Bail Hearings ~
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U e. Sentence Heartnga Tr C;1 ~) i.,7
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n. Juvenile Hsaringa a
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i. Appease Court 1 TOTAL IN ~RT CO
4 Other (S
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TOTAL HOURS a /'1 X PER HOUR $ ~ S O
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20. a Intervfsws and eonfarsncea Multiply rats par hour times total
~ b. Obtaining and reviewing records hours. Enter total "Out of Court"
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G Legal research and boat writing compenution below.
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O U d. Investlgadve and odter work (Seedy on addidortal sheets) 200. TOTAL OUT OF COURT
COMP.
TOTAL HOURS ~ • ~ X $45 ER HOUR ' S , ~ f~
2t• ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM
Mil a $. ~ er mile X
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p 210. TOTAL ITEMI2ED E%P.
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22. CERTIFICATION OF ATTORNEY/PAYEE 23. GRAN T L CLAIM D
Has compensation and/or reimbursement for work In this r..s provlousy been applied for? ^ YES ~ NO
tlyes.wereyoupaid? ^ YES Ot NO Ifyee.bywhomwroyoupslEt7 Howmueh? w s
Has the person represented pafd any money to you, to you n ledge an s else, in connection wit the alter for 24. DEDUCT. PRIOR PYMTS.
which you were appointed to provide ropresentatlon ^ YE N 4 fails on s di i ' S
1 swear or affirm the truth or corractneaa
of the above statements Sq of AM
/ yea Dats 25fNET A~ ~ CLA~ ED
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28,n1•CgOVEU
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AAYMENI Judge ~ ~/ /
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27. AMT. APPR VED
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Copy 1 -Mail to Court Administrator at completion of service f N~