Free County, State of Colorado - Colorado

COLORADO JUDICIAL DEPARTMENT REQUEST AND AUTHORIZATION FOR PAYMENT OF FEES
FOR COUNSEL, GAL (ADULT REPRESENTATION ONLY), NON-ATTORNEY CHILD & FAMILY INVESTIGATOR, COURT VISITOR, INVESTIGATOR

(Complete Sections I- VI, sign, date and submit to Court ­ See reverse side for Instructions)

I. Case Number: _____________________________ for Repr. of: ________________________________ Court: District County Case Name: _______________________________________ Number of Persons Represented: _______ County: _______________ Appointing Judge/Magistrate: ___________________________ Current Judge/Magistrate: ___________________________________ II. Appointee Information: Complete or check all that apply:
Atty. Reg. No. ______________________ Check if new address Name: _______________________ Address: __________________________ City: _______________State: ______ Zip: _________ Phone: _____________________ Fax: __________________________Email: ___________________________________________ The information in this box is confidential and NOT to be viewable in court case file
SSN/Tax ID: _______________________________ First Time Appointees: See instruction #4 on reverse (Per I.R.S. Reg. # 301.6109-1, the Social Security number of payee is mandatory for reporting on I.R.S. Form 1099.)

Appointment Date: ___________________ Original appointee or Substitute appointee Case has has not gone to trial. Originally flat fee contract appointment. Reason for hourly bill: ________________________ on __________ (date).

III. APPOINTMENT TYPE (check one):
Counsel Attorney GAL (Adult Representation Only) Non-Attorney GAL/Child Family Inv. (CFI) Investigator Court Visitor

IV. APPOINTMENT AUTHORITY (check one):
Title 14 DOMESTIC REL. CHILD(REN) State pays for _______________% Title 15 PROBATE Title 19 D & N CHILD(REN) Title 19 D & N RESPONDENT PARENT Title 19 D & N SPECIAL RESPONDENT Title 19 JUVENILE DELINQUENCY Title 19 PATERNITY/SUPPORT State pays for _______________% Title 22 EDUCATION CODE (Truancy) Title 25 DRUG/ALC. COMMIT. Title 27 MENTAL HEALTH ADVISORY COUNSEL WITNESS (CJD 04-04) CRCP 107 CONTEMPT 13-90-208 WAIVER OF HEARING INTERP. OTHER _________________________

V. INDIGENCE

Responsible party(ies) determined to be indigent on ________________ (mm/dd/yy). Not indigent, but responsible party(ies) refuse payment without good cause (appt. for JD counsel). Reimbursement to be ordered to the state. Not indigent, but responsible party(ies) refuse payment with good cause, i.e. family member victim (appt. for JD counsel). Indigence cannot be determined. Reason: ____________________________________________________________________________________
Column 1 Column 2 Column 3

VI. SUMMARY OF BILLED ACTIVITIES (see instructions on reverse)
Dates of service before 7/1/08
Activity from (mm/dd/yy) _______________ to _______________

Dates of service 7/1/08 and on
Activity from ( mm/dd/yy) _______________ to ______________

TOTAL AMOUNT
Total Hours
_______ _______ _______ _______ _______ _______ _______

Attorney
_______ out-of-court hours x $60 rate $_____________ _______ in-court hours x $60 rate _______ Appellate hours $60 rate $____________ $_____________ _______ out-of-court hours x $65 rate _______ in-court hours x $65 rate ______ Appellate hours $ $65 rate ______ hours x $25 rate $ ______________ $ ______________ $ ______________ $_____________ $_____________ $_____________ $_____________

$ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________

Paralegal

______ hours x $25 rate $__________

CFI/GAL(non-atty) ______ hours x $20 rate $________

______ hours x $25 rate ______ hours x $33 rate ______ hours x $25 rate

Investigator______ hours Court Visitor______ hours

x $33 rate $__________ x $25 rate $_________

Expenses: ____ miles x .53 (travel before 1/1/09) ___ miles x .50 (travel 1/1/09 forward) ___ miles x (other rt. ____ per §24-9-104 CRS) $ ________________ ____ copies x 10 cents per copy $ ________________ Misc. (attach itemized receipts if over $50.00): $_____ postage Total Amount Previously billed $ ________________ $ _____ long distance $ ________ other ( ) $ _______________

TOTAL REQUEST $ ________________ Total of Requests Exceed Allowed Maximum for appointment. Motion and Order for Excess Fees was granted and is attached.

The information provided in this request is true and accurate. No compensation for the services described has been received. A detailed itemization of the incourt and out-of-court hours is attached. I have reviewed "Court Appointee Procedures for Payment of Fees and Expenses" in Chief Justice Directive 04-04 or 0405 and understand that payment may be adjusted for items that do not comply with the Department's procedures. All court appointees and investigators must submit their JDF 207 (or invoice using CACS, as applicable) to the Court within six months of the earliest date of billed activity.

____________________________________________________
Signature of Appointee

______________________________
Date

Final Bill

*****Court Personnel Only****
Request has been reviewed by district staff for accuracy and completeness, and payment is approved (with adjustments as indicated, if any). Net Adjustment (+/-) $___________ Reason for adjustment (if not otherwise noted above) ________________________________________________ Reimbursement was ordered and entered in CAC On-line System when Appointment was entered. Court Staff Verified that appointment was created in CAC On-line System (to enable appointee to be paid)

________________________________________________
Signature of District Administrator, Judge/Magistrate or Designee
JDF 207 R1/09

________________________________________________
Typed or Printed Name

___________
Date

SCAO REQUEST AND AUTHORIZATION FOR PAYMENT OF FEES FOR COUNSEL, GUARDIAN AD LITEM (ADULT REPRESENTATION),
NON-ATTORNEY CHILD & FAMILY INVESTIGATOR, COURT VISITOR, INVESTIGATOR

1. HOURLY RATES
Hourly rates are paid in accordance with the applicable Chief Justice Directive (i.e. 04-04, 04-05) or Chief Justice Order.

2. MAXIMUM FEES
The maximum total fees authorized per appointment as established in Chief Justice Directive 04-05 are as follows: Title 19 ­ Dependency and Neglect Matters Respondent Parent Counsel $2,870 CFI (non-attorney) $1,250 Titles 14 and 15 Counsel (probate only) GAL (attorney) GAL or CFI (non-attorneys) Court Visitor Titles 22, 25 and 27 Counsel GAL (attorney) for adult $2,870 $2,870 $1,250 $ 500 $ 750 $ 750

Title 19 ­ Other Matters (i.e. delinquency GAL support, adoption, paternity, etc.) GAL or CFI (non-attorneys) $ 625 Appeals Counsel / GAL (attorney) for adult CFI (non-attorney) $2,870 $1,250

For maximum total fees for counsel in criminal and juvenile delinquency cases, refer to Attachment D (2) of Chief Justice Directive 04-04. If the total payment request for an appointment exceeds the maximum fee, a Motion for Fees in Excess must be submitted to the court and granted pursuant to Chief Justice Directives 04-04 and 04-05.

3. REIMBURSABLE EXPENSES
Allowable expenses are detailed in Attachments D (Guidelines for Payment) and E (Procedures for Payment) of Chief Justice Directive 04-05 and in Attachments E (Guidelines for Payment) and F (Procedures for Payment) and of Chief Justice Directive 0404. All items must be detailed, itemized, and legible. If a charge exceeds $50.00, a receipt must be attached. Chief Justice Directives are available at www.courts.state.co.us or contact the Financial Services Division of the State Court Administrator's Office for copies.

4. I.R.S. W-9 FORM AND "AUTHORIZATION TO PAY A LAW FIRM FOR ATTORNEY APPOINTMENTS" FORM
A completed W-9 form containing the appointee's Tax Identification Number (Social Security Number or Federal Employer Tax Identification Number) must be on file with the State Court Administrator's Office before payments will be processed. In addition, those appointees wishing to have payments made to a law firm instead of to the appointee personally must complete the "Authorization To Pay A Law Firm For Attorney Appointments" form. Contact the Financial Services Division of the State Court Administrator's Office for copies of these forms.

5. INSTRUCTIONS FOR COMPLETION AND SUBMISSION OF JDF 207 FORM
Use Column 1 if only one rate applies during the billing period by completing the total hours billed per category and indicate the rate charged. Use the Third column to indicate Total Charges. If a second rate applies during the billing period, note the hours and rate in Column 2. Then add the hours and charges from Column 1 & 2 per category and complete Column 3. Submit to the court two completed copies including detailed itemizations of hours. In-court attorney hours, out-of-court attorney hours, legal assistant/paralegal/law clerk hours, and other hours as described in the categories listed must be itemized separately. Hours charged must be itemized by date and detailed explicitly as to the activity involved. Abbreviations must be clarified. Requests for payment must include proof of appointment and other documentation as described in Attachment E (Procedures for Payment) of Chief Justice Directive 04-05 and Attachment F (Procedures for Payment) of Chief Justice Directive 04-04. Chief Justice Directives are available at www.courts.state.co.us. Sample Detail of Time and Expenses Out In Paralegal
6/02/08 6/10/08 6/13/08 10/08/08 10/14/08 10/08/08 11/10/08 11/10/08 JDF 207 Court appearance: advisement Conf. w/ parent and caseworker Review social worker report Conf. w/ client Prepare and submit motion for psychological evaluation Court appearance: review hearing Conference in Ft Hoodwink 13 miles 10 copies @ .10 cents = $1.00 1.0 2.0 0.5 0.3 0.5 .7

Column 1 from 6/02/08 to 6/30/08 Attorney: 2.5 Out of court hours x $60 = $150.00 1.0 In-court hours x $60 = $ 60.00 Non-Attorney: Paralegal _ hours x $25 = Expenses: 13 miles @ .53 before 1/1/09

Column 2 from 7/1/08 to 1/10/09 .3 Out of court hours x $65 = $19.50 .7 In-court hours x $65 = $45.50 .5 hours x $25 = $12.50

Column 3 Total hours Total Amount 2.8 1.7 .5 $ 169.50 $ 105.50 $ 12.50 $ $

___ miles @ .50 after 1/1/09 10 copies x .10 =

6.89 1.00 Total Request = $ 295.39

JDF 207 R1/09 SCAO REQUEST AND AUTHORIZATION FOR PAYMENT OF FEES FOR COUNSEL, GUARDIAN AD LITEM (ADULT REPRESENTATION),
NON-ATTORNEY CHIL AND FAMILY INVESTIGATOR, COURT VISITOR, INVESTIGATOR