HomeMy WebLinkAbout05-22-15 AUTHORITY TO PAY COURT APPOINTED CC.�UNS�L Q� MAY �S ZOIS �
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1.COURT 2.VOUCOHERI5 2 7 6 �
❑ District Justice �'Common Pleas ❑ Appeliate ❑ Other _. _. N
3.FOR(D.J.,C.P.,APPELLATE) 4.AT(CITY/STATE) 5.BUDGET CODE
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6. IN THE CASE OF 7.CHARGE/OFFENSE(PURDON CITATIC.)N� 8. ❑ PETTY OFFENSE
5���� ������ _ ❑ FELONY❑MISDEMEANOR
9. PROCEEDINGS(Describe riefly) t i.PERSON FiEPRESENTED 12.CIVIL DOCKET NO.
� � ����` t ❑ Defendent•Adult — �
Cc2eCLC� 2 � Defendant•Juvenile 2� � � Z�
��,�f� 3 ❑ AOpeliant 13.CRIMINAL DOCKET NO.
a ❑ Appellee
5 � Habeas Petitionar
6 O Material Wrtness
7 O Parolee Cha�ged W�Ih V+o�ation
10. PEPSON REPRESENTED(Full Name) g ❑ prpbefiOnBrC�3rq9d With ViOlat�on 14.APPEA�S DOCKET NO.
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�Cc.-Q-al..� �l.�i YaC�J� c _ 1 -_ "
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16. NAME OF hTTORNEY/PAYEE AND
Appt Dare 1 v � �1'� MAILING ADDRESS '
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NAME OF COMMON PLEAS JUOGE A SIGNED TO CASE ��y �_ ������•��'�
��IuG.s���G.ui.�tn-�i �a.. l?D 9 D
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17.TELEPHONF:No. 18. soC�A�sEcua�rrr,o oae�rvr,o
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CLAIM FOR SERVICES OR EXPENSE::i
�g, SERVICE HOUP.S C)ATES AMOUNTS CLAIMED
a. Arraignment end/or Plea Multiply rete per hour times total
�--- hour� to obtain "In CouR" com-
b. Prellminery Mearin9 _ pensation.E�r total below.
c. Motions and Requests � � r-�j-�
r d Bail Hearin9s ' Q "� � �
� e. Sentence HearinOs � _ �"; � � � ,,� �1
V _ . _� C.::7
Z f. Trial :. � .��,,. f"' ('v ,..1 r,;�
g. Revocation Hearinps y. t , N `�-a
h. Juvenile HearinQs " ' �
-�----- ' A:'TOTAL�COUR MP.
L Appeals Court �9
j. Other(Specity o�additlonal�heets) L a )�5 '�t :^�� 1 � � ---�- ��
. c.� r-- rn
_i,�.._.._. $ ���^�..�
TOTAL HOURS= ,�� X$;�r!#PER#��OUR ��` 'E��-'�� ✓
20. a. Interviews and conferences � Multipfy rate per hour times total
• hours. Enter total"Out of Court"
b. Obtaining and�eviewin9 recorda compensation below.
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0� c. Legal research and brief wrftinq
�� d.Invesdgative and other work(Specily on addidonal sheets) 20A TOTAL OUT OF COURT
O U ' ' COMP.
�$ �� 4���
TOTAL HOURS= �,� X$45 PER FiOUR �
21. ITEMIZATION OF REIMBURSABIE EXPENSES AMT. PER ITEM
Mileage$,�� per mile x � 0 r-- �"�"
W Please contact Court Administrator for current mileage rate
_ --�-�>` 'y , 02 21A. TOTAL ITEMIZED EXP.
f-
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- as �3 � . �C� „
22.CERTIFICATION OF ATTORNEY/PAYEE Y 23. GRAND TOTAL CLAIMED
Has compensation and/or roimburaement fo�work in thia Case previoualy been apPlied fon ❑ YE i ��NO =s ��Z ���
II yes,were you paid? ❑ YES O NO If yes,by whom were you paid7 How much'i _
Has the person reo�esented paid any money to you,or to your knowledge anyone elae,in connection vrith the matter for 24•DEDUCT. PRIOFi PYMTS.
which you were appointad to provide repre a 9 1r�-1�y7ES -"�NO If yes,flive details on addit'onal sh ets �S b- �l O
I swear or aHirm the truth or cortectness Y � �� F�-��' g_. ��_ '� 25:NET AMOUNT CLJ�IMED
of the above statements �n ee Dete s= 1\�-Z`-"2 �/
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� 27.AMT.APPROVED `
26 nr�v��ovt u —s �� •
F���� S�g�alure ol OffIGS�1.P�GCey �Date:��„"i��,,,1,,q
n�vr,eENr JudgB �
Copy 1 -Mail to Court Administrator at completion of service �n�
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