Appointment Of And Authority To Pay Court Appointed Counsel {CJA 30}

CJA 30 DEATH PENALTY PROCEEDINGS: APPOINTMENT OF AND AUTHORITY TO PAY COURT-APPOINTED COUNSEL (Rev. 02/12) 1. CIR./DIST./ DIV. CODE 3. MAG. DKT./DEF. NUMBER 2. PERSON REPRESENTED 4. DIST. DKT./DEF. NUMBER 8. TYPE PERSON REPRESENTED VOUCHER NUMBER 5. APPEALS DKT./DEF. NUMBER 6. OTHER DKT. NUMBER 7. IN CASE/MATTER OF (Case Name) ' Adult Defendant ' Habeas Petitioner ' Appellant ' Appellee ' Other (Specify) 9. REPRESENTATION TYPE ' D1 28 U.S.C. § 2254 Habeas (Capital) ' D4 Other (Specify) ' D2 Federal Capital Prosecution ' D7 State Clemency ' D3 28 U.S.C. § 2255 (Capital) ' D8 Federal Clemency 10. OFFENSE(S) CHARGED (Cite U.S. Code, Title & Section) If more than one offense, list (up to five) major offenses charged, according to severity of offense. 11. ATTORNEY'S NAME (First Name, M.I., Last Name, including any suffix), AND MAILING ADDRESS 12. COURT ORDER: ' O Appointing Counsel ' F Subs For Federal Defender ' P Subs For Panel ' C Co-Counsel ' R Subs For Retained Attorney ' Y Standby Counsel Appointment Date: Prior Attorney's Name: Telephone Number: 13. NAME AND MAILING ADDRESS OF LAW FIRM (A) Because the above-named person represented has testified under oath or has otherwise satisfied this Court that he or she (1) is financially unable to employ counsel and (2) does not wish to waive counsel, and because the interests of justice so require, t he attorney whose name appears in Item 11, who has been determ ined to possess the s pecific qualifications by law, is appointed to represent the person in this case. (B) The attorney named in Item 11 is appointed to serve as: ' LEAD COUNSEL ' CO-COUNSEL Name of Co-Counsel or Lead Counsel: Appointment Date: (Only provide per instructions) (C) If you represented the defendant or petitioner in any prior proceeding related to this matter, attach to your initial claim a listing of those proceedings and describe your role in each (e.g., lead in counsel or co-counsel). ' (D) Due to the expected length of this case, and the anticipated hardship on counsel in undertaking representation fulltime, for such a period without compensation, interim payments of compensation and expenses are approved pursuant to the attached order. Signature of Presiding Judge or By Order of the Court Date of Order Nunc Pro Tunc Date (E) Repayment or partial repayment ordered from the person represented for this service at time of appointment. ' YES ' NO CLAIM FOR SERVICES AND EXPENSES 14. STAGE OF PROCEEDING Check the box which corresponds to the stage of the proceeding during which the work claimed at Item 15 was performed even if the work is intended to be used in connection with a later stage of the proceeding. CHECK NO MORE THAN ONE BOX. Submit a separate voucher for each stage of the proceeding. CAPITAL PROSECUTION HABEAS CORPUS OTHER PROCEEDING e f a. b. c. d. ' ' ' ' Pre-Trial Trial Sentencing Other Post Trial ' Appeal ' Petition for the U.S. Supreme Court Writ of Certiorari g. gg. h. i. j. ' ' ' ' ' Habeas Petition State Court Appearance Evidentiary Hearing Dispositive Motions Appeal k. ' Petition for the U.S. Supreme Court Writ of Certiorari l. m n. ' Stay of Execution ' Appeal of Denial of Stay ' Petition for Writ of o. ' Other (Specify) Certiorari to the U.S. Supreme Court Regarding Denial of Stay p ' Clemency HOURS AND COMPENSATION CLAIMED 15. CATEGORIES (Attach itemization of services with dates) HOURS CLAIMED TOTAL AMOUNT CLAIMED FOR COURT USE ONLY MATH/TECH. ADJUSTED HOURS MATH/TECH. ADJUSTED AMOUNT IN COURT TOTAL Category a ADDITIONAL REVIEW IN COURT TOTAL Category a a. In-Court Hearings (RATE PER HOUR = $ ) b. Interviews and Conferences with Client c. Witness Interviews d. Consultation with Investigators & Experts e. Obtaining & Reviewing the Court Record f. Obtaining & Reviewing Documents and Evidence g. Consulting with Expert Counsel h. Legal Research and Writing i. Travel j. Other (Specify on additional sheets) TOTALS: Categories b thru j (RATE PER HOUR = ) CLAIM FOR TRAVEL AND EXPENSES (Attach itemization of expenses with dates) 16. Travel Expenses (lodging, parking, meals, mileage, etc.) 17. Other Expenses (other than expert, transcripts, etc.) OUT OF COURT TOTAL Categories b-j OUT OF COURT TOTAL Categories b-j GRAND TOTALS (CLAIMED AND ADJUSTED): 18. CERTIFICATION OF ATTORNEY/PAYEE FOR THE PERIOD OF SERVICE FROM: TO: ' Final Payment ' Interim Payment Number 19. APPOINTMENT TERMINATION DATE IF OTHER THAN CASE COMPLETION 20. CASE DISPOSITION 21. CLAIM STATUS ' Supplemental Payment Have you previously applied to the court for compensation and/or reimbursement for this case? If yes, were you paid? ' YES ' NO ' YES ' NO Other than from the Court, have you, or to your knowledge has anyone else, received payment (compensation or anything of value) from any other source in connection with this representation? If yes, give details on additional sheets. ' YES ' NO I swear or affirm the truth or correctness of the above statements. Signature of Attorney Date APPROVED FOR PAYMENT -- COURT USE ONLY 22. IN COURT COMP. 23. OUT OF COURT COMP. 24. TRAVEL EXPENSES 25. OTHER EXPENSES DATE 26. TOTAL AMT. APPROVED 27a. JUDGE CODE American LegalNet, Inc. www.FormsWorkFlow.com 27. SIGNATURE OF THE PRESIDING JUDGE