Free CJA 20 - Appointment - District Court of Arizona - Arizona

CJA 20 APPOINTMENT OF AND AUTHORITY TO PAY COURT APPDINTED COUNSEL g .. ’ - VU [_0D(_‘;gg
1. ctR.mtsT.mtv. coma z. ransom naransnwrszn voucuatz NUMBER} * F - KF “/E D __ _ C OP -
AZX Ortiz, Fcrmin
3. MAG. DKTJDEF. NUMBER -1. DIST. DKTJDEF. NUMBER s. APPEALS DKTJDEF. NUMBER 6. OTHEQQKY.
2:04-050151-001
1. IN CASEJMATTER OF (case Name) a. PAYMENT CATEGORY 9. TYPE PERSON REPRESENTED 1 IlI.FI$§PRESEN’I` TIONTYBEAP), J ,,
_ eelttstrttctio ;‘·.»'e·.» T
U.S. V. Orttz Other Adult Defendant __ Supervtsetié lease if 1 __ A E
II. GFFENSIMS) CHARGED (Cline U.S. Code, Title & Section) Ifmorethan one ofiense, lis·t(up to live) major offenses charged, according to severlty ofofllttse. i *;*1-; All TV I ·
I2. A'I'l`ORNEY‘S NAME gut Name, MJ., Last Name, including any suflixj I3. COURT ORDER ·
AND MAILING ADDR S IH 0 Appoittting Counsel EI C Co-Counsel
GONZAI EZ, ALEX D_ ij P sum Por reoemt Defender tj R Subs For Retained Anomey
181 1 S ALMA SCHOOL ROAD #230 EI P Subs For Panel Attorney I] Y Standby Counsel
MESA AZ 852 I 0 Prior Attorneys Name:
Appointment Date: _ _
CI Because the alsovenamed person represented has testified under oath or has
_ otherwise satirlied this court that he or she (I) is financially unable oo employ counsel and
Telephone Numb", I (2) does not wiah to waive cou · sel, and because the interests ofjustice so require, the
attorney whose name appears in Item I2 ls appointed to repruent this person in this case,
I4. NAME AND MAILING ADDRESS OF LAW FIRM(onIy provide per instruction:) or
[1 Other (See hun-neon - ,
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Signature of Presiding Judicial ttzer or By Drder of the Court
L;...............
Date of Order Nnnc Pro Tunc Date
. Repayment or partial repayment ordered from the person represented for this service at
time of appointment. [I YES U N0
CATEGOR1ES(Attach itemiutioo ereemteee wat dates} CEQFQQD Amount AD.msTED ADJUSTED ’*§g{,”{!E‘{{,`”*'·
y CLAIMEII HOURS AMOUNT .
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19. CERTIFICATION OF ATTORNEYIPAYEE FOR THE PERIOD DF SERVICE 211. APPOINTMENT TERMtNAT10N DATE 21. CASE DISPOSITION
FROM TD _ rr oruan mm casa coatvtartoa
22. CLAIM STATUS EI Plnat Payment [J tate.-am Payment Numan- I] Supplemental Payment
I-lava you previously applied to the court for eompettsation andlor remimbursement for this case? I] YES [I NO Ifyes, were you paid? I] YES I] NO
Other than from the court, have you, or to your knowledge has anyone else, received payment (compensation or anything or value) from any other source In connection with this
repruentation? EI YES [I N0 Ifyrs, gtve details on additional sheets.
I swear or affirm the truth or correctness of the above statements.
Signature ofAttnrttey: Bate:
23. IN COURT COM P. 24. OUT DF COURT COMP. 25. TRA EXPENSES 26. OTHER EXPENSES 27. TOTAL AMT. A1·PR.rt:Etrr
28. SIGNATURE OF THE PRESIDING JUDICIAL OFFICER DATE zsa. JUDGE 1 MAG. JUDGE cone
29. IN COURT COMP. 30. OUT OF COURT COMP. 3t. TRAVEL EXPENSES 32. OTHER EXPENSES ss. TDTAI. AMT. APPROVED
34. SIGNATURE OF CHIEF JUDGE, COURT OF APPEALS (OR DELEGATE}Pnyntutl DATE sta. JUDGE CODE
approved In excess of the statutory threshold amount. _
Case 2:O4—cr—50151—NVW Document 21 Filed 05/10/2006 Page 1 0f1

Case 2:04-cr-50151-NVW

Document 21

Filed 05/10/2006

Page 1 of 1