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

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CTA zu APP 0D~1TMENT OF AND AUTHORITY TO PAY COURT APPOINTED COUNSEL RECEIVED Cgpy
1. CIRJDISI`./'DIV. GDDE 2. PERSON REPRESENTED vcucamx NUMBER
AZX Gaytesu, Demus . I _
:1. MAG. DKT./DEF. NUMBER 4. DIST. D1 2:04-007173-001 cg¤.2:U4-001202-OU3 gg , __ _ _ _ CT r .

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T. TN OASEJMATTER OF (um Name) P. PAYMENT CATEGORY 9. TYPE PERSON REPRESENTED Io. RE RESE . * J .. . A HT
I
(S} strncti “ .'i\ ul LJ
U. S. v. Gaytzm Felony Adult Dcfcimdant CP1 L C e U P AH-W
[I. OFFENSE[S) CHARGED {Cite U.S. Cade, Title & Section) lfmor: than one offense, list (np to live) nsajor ofhnses eharged, according to severity of ffe I — I ww"; ` ` M ” M- -- -
I) 42 40S.F -— MISUSE OF SOCIAL SECURITY NUMBER
12. ATTORNEY 'S NAIVIE (First Name, MJ., Last Name, inclnding any snflix) 13. COURT ORDER
AND DIAILING ADDRESS IE 0 Appointing Conasd 1: C Co-Cannsel
TAYLOR NEAL C E $ EEZ; E ZE $§Z2?.1.?JI§Z°" E $ EZ.'L’£L§'¤”§ZTZZf“ A" °'‘° ’
Stute #15 00 _ "
I 1 1 MOHIOE P1-Tor At1nrn:y's Name:
Phgenjgg AZ, 85003 AP|"’i'“““‘D“'°’
[I Beranse the above-named person represented has tes titled uder oath or has
otherwise satished this cout tht he or sh: fl) is finaneially nnable to employ eunsel and
Tdephun Nlmhtn [ [Z) does not wish to waive counsel, and heeans: the interests ofjnstice so reqnire, the
attorney whose name appears i.n Item 2 is nppointed to represent this person in thh mee,
14. NAME AND MAILING ADDRESS OF LAXV FIRJNI (only provide pertnstructions) or U·_»
BURNS, NICKERSON AND TAYLOR S °"'"[S""""”"°"’)
Signature o esa ing Judicial icer or By Or er of the Court
AZ Dale •f0rder Nnnc Pro Tue Date
Repayment o r partial repayment ordered from the person represented for this s ervice at
tineofappointment. I] YES Zi NO
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TOTAL MATHfI`ECI-I MATHJTECH .
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19. CERTIFICMION OF ATTORNEY/PAYEE FOR THE PERIOD O F SERVICE 20. APPt_?{I1~TETk~.grENT Té?A!g1\élg3]k1;PQ[‘l\£c¥?gP¥Z 21. CASE DISPOSITION
FROM ______, TO _ IF °
22. CLAIM STATUS I:] Final Payment D Interim Payment Nnmluer _,,_, I] Supplemental Payment U
Have yon previously applied to the eonrt I'tn· compensation andlor reirtiralsnrsemenl for this use? ij YES Ci N0 If yes, were you paid? I;] YES I [Ii NU
Other than from th: song, have yon, or toyonr knowledge has an one else, received payment [compensation or anything or value) from any other source in connection wath this
representation? YES [Zi N0 If yes, `ve detaiis on additional sheets.
lswear 0I' 2.fi·ll'I‘l‘l the iII'I.luI 0I' C0l"l'BlZ'tlIIBS5 0fEI'lE llb0VE SIIIEITIIIIIS.
Signatnre ¤fAttorney: Dale:
‘¢€"=5"=¢5‘=E5*25="i§¤E§=*E‘=*i*=E*=`i’=*i I‘*=·?··;"°*i';?;i’£$§?’?’$?.’P’?$*Sli?ZEE?Ei??E;€??E?¥**¢'$???*€?‘i€E‘i?E¥?"*E?"*°°i "’ ‘'‘`- =5 ’‘‘· *1** ‘·* ‘·‘·'‘``·`‘`·` Z "`‘`‘ T “:% ‘`‘`‘ ° ‘``' 2"‘T5F;*E-25*;%%;§5:*ai?;=;5F;=·5

2.3. INCOURT COMP. 24. OUT OF COURT COMP. 25. TRAVEL EXPENSES 26. OTHER EXPENSES 21 TOTAL AMT. APPR: CERT
28. SIGNATURE OF THE PRESIDEWGJTJDICIAL OFFICER ` DATE ess. .1m>cn: r MAO. JUDGE CODE
29. IN COURT COMP. $0. OUT OF COURT COMP. 31. TRAVEL EXPENSES J2. OTHER EXPENSES J:. TOTAL AI\rl'l'. APPROVED
14. SIGNATURE OF OHTEE JUDGE, COURT or APP EALS (OR DELEGATE) Payment DATE us. JUDGE c0DE
npprnveel tn exeesa of the statntory threshold amonnt.
Case 2:04-cr-01202-JAT Docu ment 121 Fnled 10/06/2006 Page 1 of 1

Case 2:04-cr-01202-JAT

Document 121

Filed 10/06/2006

Page 1 of 1