HomeMy WebLinkAbout04-13-05
AUTHORITY TO PAY COURT APPOINTED COUNSEL
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RECEIVED APR 0 6 200~
1. COURT 2. VOUCHER
o District Justice o Common Pleas 0 Appellate o Other N~ 9540
3. FOA (OJ.. C.P., APPELLATE) 4. AT (CITY/STATE) 5. BUDGer CODE
/trd- /''57.:u IJ.J /) 11..1/)1)
6. IN THE CASE OF 7. CHARGE/OFFENSE (PURDON CITATION) 8. 0 PETTY OFFENSE
vs o FELONY 0 MISDEMEANOR
9. PROCEEDINGS (Describe briefly) 11. PERSON REPRESENTED 12. CIVIL DOCKET NO. ,
T.r1cOfpac ,'hi Ht()r/~ 1 0 Delendant . Adult {i It'I../r-rns
2 0 Defendant. Juvenile ott~s- (}d-tl;)-
3 0 Appellant 13. CRIMINAL DOCKET NO.
4 0 Appellee
5 CJ Habeas Pelitioner
6 0 Material W,lness
7 o Parolee Cnarged Witn Violation
10. PERSON REPRESENTED (Full Name) 8 0 Probationer Charged With Violation 14. APPEALS DOCKET NO.
)3e..ve.....lV\ ~~rd 9 o Olher:
I 16. NAME OF ATTORNEY/P~~ ~ > -oi
Appl Dale .D1tMr:h 4) ~ MAILING ADDRESS -.,.... . ~ u
N\icho..eJ (V'l, J-ef""~YYhnS~\'""\ L~
7ht H~nt1rohk (/. IJII?SIP'i (J/Rf ('7f-:
a1J s. P It-t 'Street
NAME OF COMMON PLEAS JUD E ASSIGNED TO CASE Co.rI,Sle\ ~A l/6l :,
11 JcJ'icJ1)
~'Jr:PHONE No. fl~ 16. SOCIAL SECURITY NO OREINNO
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CLAIM FOR SERVICES OR EXPENSES
19. SERVICE HOURS DATES AMOUNTS CLAIMED
a. Arraignment and/or Plea Multiply rate Pe" hour times tOlal
b. Preliminary Hearing ltours to obt.jj,.:~ln Court~com'
IM!lI$ation. Enter >,total below. .
c. Motions and Requests
t- d. Bail Hearings
ce .'_.. "
j e. Sentence Hearlngs ,
0 ;-.,.'.
0 f. Trial
~
g. Revocation Hearings : -'
h. Juvenile Hearings ..: '.;'
i. Appeals Court 19A. TOTAL IN ~gURT COM~:i
j. Other (Specify on additional sheets) c.;i
:[(1 COf/rf /~I (' ctri 3.:)0 "1$ pO = $ III ~ . '6"'0
TOTAL HOURS .. X ~ER HOUR
20. a. Interviews and conferences Multiply rate per hour times total
b. Obtaining and revlewiliQ records hours. Enter total "Out of Court"
"-t- compensation below.
Oce c. Legal research and brief writing
t-:;:)
jO d. Investigative and other work (Specify on additional sheets) 20A. TOTAL OUT OF COURT
00 COMPo
TOTAL HOURS = X $40 PER HOUR -$
21. ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM
Mileaoe $.25 oar mile lC
ce
w
:z: 21A. TOTAL ITEMIZED EXP.
t-
O
-$
22. CERTIFICATION OF ATTORNEY/PAYEE 23. GRAND TOTAL CLAIMED
Has compensalion and/or reimburwemenl for work In Ihls ClUJe previOUSly been applied for? DYES o NO =$ )lj r 5b
If yes, were you paid? o YES o NO It yes, by whom _re you paid? How much?
Has the person represented paid any money 10 you, or 10 your knowledge anyone else, in connection with the matter for 24. DEDUCT. PRIOR PVMTS.
which you were appointed to provide represenlatlo~ES 0,(10 If yes, give details on additi~al sheetll =$
I swear or affirm the truth or correctness /1"'1. '16/(fi 25. NET AMOUt~ CLAIMED
of the above IItatements Signature o')ffijmfrJ/Payee/1 /' Date ... $ J).j ,~D
26 A"pnOVI (ll "".J L//c-, (/ nF j . OSIe: 1J P <:: dry. ') lJ) oS 27. AMT. A,P~ROVED
. "'" Signature of -$ \ ~ SO
PAYME.NT Judge
#py 1 . Mail to ~Admlnistr~~or at completion of service