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AUTHORITY TO PAY COURT APPOINTED COUNSEL �
t.COURT 2.V UCHER 14 6��
❑ District Justice �Common Pieas 0 Appellate ❑ Other N O
3.FOR(D.J.,C.P.,APPELLATE) 4.AT(CITY/STATE) 5.BUOGET CODE
: G�. CarL."s�� C'�1 - - D�
6.IN THE CASE OF��8���� 7.CHARGE/OFFENSE(PURDON CITATION) 8. O PETTY OFFENSE
Ct�L�fcT�E�. � O FELONY O MISDEMEANOR
9.PROCEEDINGS(Describe briefly) 11.PERSON REPRESENTED 12.CIVIL DOCKET NO.
1 �Dsfendant-Adult
�"^ c�� '�-C�� ��-�C�-�� 2 O Oefendant•Juvenile �C �Z 1 — �3 ,—Q)�3
� 3 ❑ Appellant
4 ❑ Appeuee 13.CRIMINAL OOCKET NO.
5 O Mabeas Petitioner
6 � Material Wrtness
7 O Paro(ee Charged With Violation
10.PERSON REPRESENTED(Fult Name) g p Probationer Charped Wit�Violation 14.APPEALS DOCKET NO.
�, �J\��� 9 O Other.
��11�.}?e �
2 � �� 16.NAME OF ATTORNEY/PAYEE ANO
appt Oate 3 MAILING ADDRESS_
�.LIN� LAW QFFICE
orn� A .����� 714 Bi•idge Street
Post Office Box 461
NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE New Cumberland, PA 17070
17.TELEPHONE No. 18. SOCIAISECURITYNO OREINNO
�1�''�' -'2��0
CLAIM FOR SERVICES OR EXPENSES
19. SERVICE HOUP.S DATES AMOUNTS CLAIMEO
a. Arraiqnment and/or Ples Multiply rate per hour times total
hours to obtain "In Cs.µrt" com-
b. Preliminary Heatinq pen�jon.Enter tota�low.�
c. Motions anG Requeats C Q w �
¢ d Bail Hearinps � � � � Q
� e. Sentence Hearinqs !"�T � C-j � Gr3 �
V f. Triat . 2 O 1 �"' � � � rT1 �i
2
: g. Revxation Hearinqs , �"' � � � � �
� . � p O
h. Juvenile Hearinys C7 � -� -�
i. Appeals Court 19A.� MlCO CO�p..,_„
I. Other(Specify on additional aheets) r �7 � n
� � �
TOTAL HOURS� � � 5�-� � O
�.Z X$65 PER HOUR � vrJ
20. a tnterviews and conbrencea "z, Multiply rate per hour times total
b. Obtaining and reviewiny records
hours. Enter total"Out of Court"
� � . 1 compenaation below.
�¢ c. legal researCh and brief writinp
H�
Q V d.Invesdgadve and other work(Specify on addidonal sheets) 20I1 TOTAL OUT OF COURT
COMP.
TOTAL HOURS= ��p X$45 PER HOUR =$ ���•U� ✓
2t. ITEMIZATION OF REIMBURSABLE EXPENSES AMT.PER ITEM
Milea e$ t�per mile x Z �y�
W Please contact Court Administrator for current mileage rate
0 21I1 TOTAL ITEMIZEO EXP.
a s �� '�� ✓
22.CERTIFICATION OF ATTORNEY/PAYEE 23. GRAND TOTAL CLAIMED
Has compensation and/or roimburaeme�t tor wortc in thta case proviousy been applled foR O YES �'RO =s 2�O-���C�
II yes,were you paid? O YES O NO If yes.by whom were you peld? How muchl 24.OEDUCT.PRIOR PYIIATS.
Has the person represented paid any money to you.or to your knowledge anyone else,In connection with the matter for
which you were aDPointed to provide represent on O S fiYl�O If yes,qive details on eddit'cna sheets a S '"`
I swear or afiirm the truth or con.ectness ,�- �a� 25:NET AMOUNT CLJ►IMED
of the above stetements Stqnaturs of Attomey/Payee Oate s s Z b�� �� �
26,A�'PqUVEU 2T.AMT.APPROVED
Fc�r, Signature of , �^ s s
��rMErvr Judge � �_... ►Oate: �
Copy 1 -Mai1 to Court Administrator at completion of service '
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