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AUTHORI7Y TO PAY COURT APPOtNTED GOUNSE�
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6.IN 7tlE CASE OF 1-� �, '7�4 r� �_ ��`��,C 7.CHAAGEI FF NSE(PURpON CITATlON) 8. � PETTY OFFENSE
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9.PROCEEOINGS(Qescribe briefty� 11,pER$ON REPRESENTED 12.ClVfL DOCKfiT NO. -
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10.PEASON REPRESSNTED(Puli Nama} 7 O Parolee ChBrgBd Wit�YOl�tion
a o P�o6atw/nef�CAarped Witn yioieCro�n 14,APPEAIS DOCKET NQ.
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C �� ��� 18.NAME OF ATTORIYEY/PAYEE AIVD
Appl Oate MAI�ING ADDRESS
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NAME OF CO MON PLEA$JUDGE ASSIGNED TO CASE `�li'� �'`r��� S�
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Ci.AiM FOR SERViCES OR EX�'ENSES
14. SEAVICE HQURS OATES AMOUN�S CLAIMED
a.Arraipnmant end/or Pls� Muitiply rats-i,�qr hour,Um�7total
b. Pretiminery Hsariop urr to obTqln"In C�urCriom•
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TOTAL tiQUii$a � ��� X�pER kOUR S �� '1�`� �I��,
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20. a. Interviews and conferencsa p � � �� Multip{y rate per hour times total
b. Obtaininq and raviawinp recwda hours.Enter totsl"Oul ol CouR"
�� � tompensation belcw.
r� c.legai reeearch antl bNet writinQ
�O d.ln�esdg�snve a�a!!±_w.vmh�cFedt�:n additk�,."shaBC'
U U � �S 6 1f� ;1�tLi ZOA TOTAL�UT pF COUfiT
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TOTAL HOURS� �, � X�46 PER HOUR s � �C..�• f ��
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2�• ITEMIZATtC?N OF REIMBURSABLE EXPENSES AMT:RER iTEM
Milea ,y"� er mile x �,�r„ �
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F' 21A TOTAi,iTEMtZED EXP.
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22.CER7lFiCATiON OF A7TORMEY/PAYEE 23. QRAND TO'i'AL CtA1MED
Haa comp�nsation and/or rsimbursement for work in thla oaas prevlcu�ly bean apptEed toR q YES �NQ :S �� , C''� �
1lyes.wereyoupaid? � 7�3 �NO Ifyea,bywhomws�eyoupsid7 Howmuch? 2q,pffDUCT. RIORPYIYITS.
Has the person repreaented pald ariy money to you,or to your knowledge anyone elae,fn conaection wlth the mattet fo�
which yau were avPolnted to provide represe fo Y� O ysa,Qive detalls on addflio al a�heeta `�s D ` `
!swear ot altirm the truth ar cortectnsas .`✓`a- • � 3 a i�1 25:N£'T AMOUN7 CLAIMED
of tha above ytatements , $ nature of Attomsy/Pa '�--��Dat�
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��,�r""�°�eCi Sgnaturo of 27.AMT.AP OVED
P,�VMENi �udqe ► ►Oata � 's 2 Y • �
Copy t -Mall to Court Administrator at compietion of senrice ��
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2109 MARKET STREET•CAMP HILL, PENNSYLVANIA 17011
MARK E.HALBRUNER (717) 731-9600• FAX:(717) 731-9627 BRANCH OFFICE:
CRAIG A.HATCH,CELA 3 WEST MONUMENT SQUARE,SUITE 304
Certified as an Elder Law Attorney by CORRESPONDENCE ADDRESS: LEWISTOWN,PA 17044
the National Elder Law Foundation Camp Hill Office (717)248-6909
CLIFTON R.GUISE WEB SITE:
Also Admitted to practice before the www.hhgllp.com STACEY L.NACE
U.S.Patent&Trademark Office Paralegal
TRACI L.SEPKOVIC
Paralegal
JOHN H.MCCULLOUGH TRACI L.HILFERDING
Of Counsel November 3, 2014
Paralegal
VIA U.S. FIRST CLASS MAIL
Court Administrator's Office
Cumberland County Courthouse
Attn: Lana K. Davis
One Courthouse Square
Carlisle, PA 17013
RE: In re: Zachary T. Pritchett, an alleged incapacitated person
Docket No. 21-2014-0848
Dear Ms. Davis,
Please find enclosed the Authority to Pay Court Appointed Counsel for Attorney John
McCullough in the above-referenced case.
If you have any questions please feel free to contact Attorney John McCullough. Thank you.
Sincerely,
%�%'���
Traci L. Hilferding, Paralegal
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Enclosure