HomeMy WebLinkAbout02-08-07
16. NAME OF ATTORNEY/PAYEE AND
MAILING ADDRESS
f(\rd\ae.\ rfI JeromIl1~1'
7t;ro l-aw o~'FIc-e'S>
dO ~ Pitt- &-
Cor/Isle I PA /70/5 -Ir/:J. tdo
17.TELE~lJ~~~~~~
CLAIM FOR SERVICES OR EXPENSES
HOURS DATES
AUTHORITY TO PAY COURT APPOINTED COUNSEL
1. COURT
o District Justice 0 Common Pleas
3. FOR (D.J., C.P., APPELLATE)
o Appellate 0 Other
4. AT (CITY/STATE)
6. IN THE CASE OF
7. CHARGE/OFFENSE (pURDON CITATION)
vs
9. PROCEEDINGS (Describe briefly) ,
:r n(a paC, f Y Ilea r / r!J
11. PERSON REPRESENTED
1 0 Defendant. Adult
2 0 Defendant. Juvenile
3 0 Appellant
4 0 Appellee
5 0 Habeas Petitioner
6 0 Malerial WItness
7 0 Parolee Charged Wilh Violation
8 0 PrObal1oner Charged With Violation
9 0 Other:
10. PERSON REPRESENTED (Full Name)
h:>(1~(lm, n Free-\::
...J
ApPI Dale
The> )frnlan hIp ~d()(J'~, ~a..l/blf
NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE
19.
SERVICE
I-
a::
~
o
(.)
~
a. Arraignment and/or PI..
b. Preliminary Hearing
c. Motions and Requests
d. Bail Hearings
II. Sentence Hearings
f. Trial
g. Revocation Hearings
h. Juvenile Hearings
i. Appeals Court
~ Other (Specify on additional sheets)
TOTAL HOURS os
x $50 PER HOUR
20. a Interviews and conlerences
.... I- b. Obtaining and reviewing records
o ex: c. Legal research and brief writing
I-~
5 8 d. Investigative and ocher work (Specify on additional sheets)
TOTAL HOURS =
(;"co
41 '-IS. c:>o
X WPER HOUR
21. ITEMIZATION OF REIMBURSABLE EXPENSES
Mileaoe $.25 oar mile lC
AMT. PER ITEM
a::
w
:x:
I-
o
22. CERTIFICATION OF ATTORNEY/PAYEE
Has compensation and/or reimbul'1lement for work In this case previOUSly been applied for? 0 YES 0 NO
If yes, were you paid? 0 YES 0 NO If yes, bywhom_reyou paid? How much?
Has the person represented paid any money to you, or to your knowledge anyone else, In connection with the matter for
which you were appointed to provide representatlonb 0 YES 0 NO _If y~s, give details on additiopal sheets
I swear or affirm the truth or correctness AIk ~ /2 ~t.1La S-
of lhe above statements ~natu~f Atto~ey/Payee Date
~. //~l
26.^I'PROVl ((I I S' t of
f(JU .gna ute
P"YM~"" Judge
~~te:
j' l (j;( &r
---
Copy 1 - Mail to Court Administrator at completion of service
--f ~ MAR 1 0 2005 vi'
2. Vff~HER- 9527
5. BUDGET CODE
I !t1) ~ J.cl ~ ~ ^ - &O.,)df R /)
8. 0 PETTY OFFENSE
o FELONY 0 MISDEMEANOR
12. CIVIL DOCKET NO. I
() (2..P Jdr-m S
cJ~OS-OO!i~ &'M.I.-
13. CRIMINAL DOCKET NO.
14. APPEALS DOCKET NO.
18. :J'r:'/~7Z7~C/
AMOUNTS CLAIMED
Multiply rale per hour times lotal
hours to obtain "In Court" com-
pansation. Enter total below.
-2
.:;;:0
'5;G
::::X::C-)
,., ,]0; r:;:;C, =<':1
_ '~~TAL ~ou::~p
.t.
... Multiply ra~r ho(j'rtl~total
hours. Ent4!!JOtal "Out ofei:lurt"
compensation below.
20A. TOTAL OJJT OF COURT f
COMPo /:LfI COor-
:a $ d 7b. 00
21 A. TOTAL ITEMIZED EXP.
-$
23. GRAND TOTAL CLAIMED
=S~?rJ(1 . (J{)
24. DEDUCT. PRIOR PYMTS.
-$
25. NET AMOUNT CLAIMED
= $ c?'7 () . f1-{'J
27. AMT. APPROVED
"S . aJ
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