Free CJA 31 - Death Penalty Proceedings: Ex Parte Request for Authorization and Voucher Expert and Other Services - Missouri

OCJA 31 DEATH PENALTY PROCEEDINGS: EX PARTE REQUEST FOR AUTHORIZATION AND VOUCHER EXPERT AND OTHER SERVICES (Rev. 5/99)
1. CIR./DIST./ DIV. CODE 3. MAG. DKT./DEF. NUMBER 7. IN CASE/MATTER OF (Case Name) 2. PERSON REPRESENTED 4. DIST. DKT./DEF. NUMBER VOUCHER NUMBER 5. APPEALS DKT./DEF. NUMBER 6. OTHER DKT. NUMBER

8. TYPE PERSON REPRESENTED

9. REPRESENTATION TYPE

G Adult Defendant G Appellant G Other G Habeas Petitioner G Appellee

G D1 28 U.S.C. § 2254 Habeas G D2 Federal Capital Prosecution

G D3 28 U.S.C. § 2255 (Capital) G D4 Other

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.

REQUEST AND AUTHORIZATION FOR EXPERT SERVICES
11. ATTORNEY'S STATEMENT
As the attorney for the person represented, who is named above, I hereby affirm that the services requested are necessary for adequate representation. I hereby request:

Z OR G Authorization to obtain the service. Estimated Compensation and G Approval of services already obtained to be paid for by the United States pursuant to the Criminal Justice Act. (See Instructions) Signature of G Panel Attorney G Retained Attorney G Pro-Se G Legal Organization
ATTORNEY'S NAME (First Name, M.I., Last Name, including any suffix), AND MAILING ADDRESS

Date

Telephone Number:
12. DESCRIPTION OF AND JUSTIFICATION FOR SERVICES (See Instructions)
01 G Investigator 15 G Other Medical 02 G Interpreter/Translator 16 G Voice/Audio Analyst 03 G Psychologist 17 G Hair/Fiber Expert 04 G Psychiatrist 18 G Computer (Hardware/ 05 G Polygraph Software/Systems) 06 G Documents Examiner 19 G Paralegal Services 14. COURT ORDER Financial eligibility of the person represented having been established to the satisfaction, the authorization requested in Item 11 is hereby granted. 07 G Fingerprint Analyst 20 G Legal Analyst/Consultant 08 G Accountant 21 G Jury Consultant Signature of Presiding Judicial Officer or By Order of the Court 09 G CALR (Westlaw/Lexis, etc.) 22 G Mitigation Specialist 10 G Chemist/Toxicologist 23 G Duplication Services Date of Order Nunc Pro Tunc Date 11 G Ballistics (See Instructions) Repayment or partial repayment ordered from the person represented for this service at time of 13 G Weapons/Firearms/Explosive 24 G Other (Specify) 14 G Pathologist/Medical Examiner G YES G NO Check the box which corresponds to the stage of the proceeding during which the work claimed at Item 16 was performed even if the work is intended to be 15. STAGE OF 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. a. b. c. d.

13. TYPE OF SERVICE PROVIDER

G G G G

CAPITAL PROSECUTION
Pre-Trial Trial Sentencing Other Post Trial e f.

G Appeal G Petition for the
U.S. Supreme Court Writ of Certiorari

g. h i. j.

G G G G

HABEAS CORPUS
Habeas Petition Evidentiary Hearing Dispositive Motions Appeal k

G Petition for the
U.S. Supreme Court Writ of Certiorari

l. m. n.

o G Other G Stay of Execution G Appeal of Denial of Stay G Petition for Writ of Certiorari to the U.S. Supreme Court Regarding Denial of Stay

OTHER PROCEEDING

CLAIM FOR SERVICES AND EXPENSES
16. SERVICES AND EXPENSES (Attach itemization of services with dates)
a. Compensation b. Travel Expenses (lodging, parking, meals, mileage, etc.) c. Other Expenses

FOR COURT USE ONLY
AMOUNT CLAIMED MATH/TECHNICAL ADJUSTED AMOUNT ADDITIONAL REVIEW

GRAND TOTALS (CLAIMED AND ADJUSTED):
17. PAYEE'S NAME (First Name, M.I., Last Name, including any suffix), AND MAILING ADDRESS

TIN: CLAIMANT'S CERTIFICATION FOR PERIOD OF SERVICE FROM CLAIM STATUS G Final Payment G Interim Payment Number Telephone Number: TO G Supplemental Payment

I hereby certify that the above claim is for services rendered and is correct, and that I have not sought or received payment (compensation or anything of value) from any other source for these services.

Signature of Claimant/Payee
18. CERTIFICATION OF ATTORNEY I hereby certify that the services were rendered for this case.

Date Date

Signature of

APPROVED FOR PAYMENT -- COURT USE ONLY
19. TOTAL COMPENSATION 20. TRAVEL EXPENSES 21. OTHER EXPENSES 22. TOTAL AMOUNT APPROVED/CERTIFIED 23. G Either the cost (excluding expenses) of these services does not exceed $300, or prior authorization was obtained; OR G In the interest of justice the Court finds that timely procurement of these necessary services could not await prior authorization, even though the cost (excluding expenses)

Signature of Presiding Judicial Officer
24. TOTAL COMPENSATION 25. TRAVEL EXPENSES

Date
26. OTHER EXPENSES

Judge/Mag. Judge Code
27. TOTAL AMOUNT APPROVED

28. FOR REPRESENTATIONS COMMENCED AND APPELLATE PROCEEDINGS IN WHICH AN APPEAL IS PERFECTED ON OR AFTER APRIL 24, 1996,
A. B. Total compensation and expense payments approved to date (include amounts withheld for interim payments) for investigative, expert and other services for this representation is Payment approved (compensation and expenses) in excess of the statutory threshold for investigative, expert and other services under 21 U.S.C. § 848(q)(10)(B).

Signature of Chief Judge, Court of Appeals (or Delegate)

Date

Judge Code