HomeMy WebLinkAbout04-18-06
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AUTHORITY TO PAY COURT APPOINTED COUNSEL RECEIVED APR 0 5 7rr~,
16. NAM. E OF ATTORNEY/P. AYE.E AND. Jr~ ~~
MAILlNS', ADDRESS " 1U:i!,., ., 'iI.
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18. SOCIAL SECURITY NO OR E IN NO
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1. COURT
o District Justice ,~Common Pleas
3. FOR (DJ., C.P, APPELLATE)
C,P
6. IN THE CASE OF
1 n R~ " Li i/,"{Lil r-r ~ U ;''1tZ-
9. PROCEEDINGS (Describe briefly)
GV.ClFCLec nSh,'p hecl.r' ":>
o Appellate 0 Other
4. AT (CITY/STATE)
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7. CHARGE/OFFENSE (pURDON CITATION)
11. PERSON REPRESENTED
1 0 Oe'endant ,Adult
2 0 Oelendant. Juvenile
3 0 Appellant
4 0 Appellee
5 0 Habeas Pefitioner
6 0 Mateflal WItness
7 0 Parolee Charged WIth Violation
a 0 ProbatIoner Charged With VIolation
9 )it Olhe~ qlA.<'-'J.;c..,,':,\';,t'
10 PERSON REPRESENTED (Full Name)
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ADPf Date"
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NAME OF'COMMON PLEAS JUDGE ASSIGNED TO CASE
17. TELEPHONE No.
111- .:lYI-L\4:3b
CLAIM FOR SERVICES OR EXPENSES
19.
SERVICE
HOURS
DATES
~
IX:
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o
U
Z
a. Arraignment and/or Plea
b. Preliminary Hearing
c. Motions and ReQuests
d Bali Hearings
e. Sentence Hearings
I. Tnal
g. Re~ocalion Hearings
h. Ju~enlle Hearings
I. Appeals Court
j. Other (Specify on additional sheets) n I 1\ cd.; (,-.-{c,\".~{') l.~':1\ .-:,
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lI.Au H,l,. 1.'_ .Jtj.~t:;, fH) I u: L. 1l..J- AJ ~M A..L I
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3i~7s loG-)
X ~ MHOUR
TOTAL HOURS '"
20. a. Interviews and conferences
u. ~ b. ObtaIning and re~iewing records
o IX: c. Legal research and briet writing
~:)
6 8 d. Investigative and other work (Specify on additional sheets)
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TOTAL HOURS =
1.0
X $45 PER HOUR
21.
ITEMIZATION OF REIMBURSABLE EXPENSES
AMT. PER ITEM
Milage $.345 per mile
x
a:
w
:I:
....
o
22. CERTIFICATION OF ATTORNEY/PAYEE . /
Has compensation and/or reimbur$ement for wo~ In this caae previoUSly been applied 1011 0 YES tf NO
If yes, were you pa,d? 0 YES 0 NO II yes. by whom were you paid? Howmuch1
Has the person represented paid ~ny money to you. or to your knowl.egge anyone ela.e. In connection with Ihe matter lor
which you were apPointed 10 prOVide repreaenlatlon2, 0 YES /1It()40, I~ ~es. give delalls on addlh<jlnal(ahepta
I swear or affirm the truth or correctness .Af!7Lr'A f -1:.>. 1".{}~ ' 'J c-! _ c ~
of the above statements SlOna!fre of Altomey/P.qee Date
26 APPI1UVl (, \
. Ftm Signature of
PA,YMtNT Judge
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~Dale;
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Copy 1 . Mail to Court Administrator at completion of service
2.VNrER 10748
5. BUDGET CODE
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8. 0 PETTY OFFENSE
o FELONY 0 MISDEMEANOR
12. CIVIL DOCKET NO.
~1-C6 -0/40
13, CRIMINAL DOCKET NO
14. APPEALS DOCKET NO
AMOUNTS CLAIMED
Multiply rate per hour lImes lotal
hours to obtain--'In Court" com.
~nsalion. Entmotal below,::C;
Co C7" rn
[15 ;.g ~ :~~$
'.r1:r: ("):::0 Jl
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:~~~~ ~ ,-.'8
.-1(:')0 -U C?
'-:! 52 "Tl :x ':: ;.j
1 9A;:!:t:)T AL I N<G:DURr:"COM?.
~ (, ik 57J'"
=$ ~C
Multiply rate per hour times total
hours. Enter tolal "Out 01 Court"
compensation below.
20A. TOTAL OUT OF COURT
COMP,
'" $ L.{5.o0
21A. TOTAL ITEMIZED EXP.
>=$
23. GRAND TOTAL CLAIMED
=$ I ~50/1J.s<
24. DEDUCT:' PRIOR PYMTS,
=s
25. NET AMOUNT CLAIMED
= S I ,;L~" 112.5'0
27. AMT. APtS'ROVE~"\
= $ JJ:J.~U
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