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

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CJA zu APPOINTMENT Or AND AUTHORITY TO PAY COURT APPOINTED COUNSEL E CE! WED CO PY
. 1. C1R.rDIST..IDIv. CODE 2. PERSON REPRESENTED VOUCI-IER N ·
AZX Martinez .i1”.,.l"l13]1 De Dios ; , | | ,
3. MAG. DKTJDEF. NUMBER 4. DIST. DKTJDEF. NUMBER s. APPEALS DK'I`..'DEF. NUMBER 6. OTHER DKT. `NUMBER
2:03-003127-001 ’ 2:03000606-001 [hl-lr CLERK U Q @15TT • RT
7. IN CASEJMATTER OF [cm Nam] a. PAYMENT CATEGORY 9. TYPE PERSON REPRESENTED ig. T’Y57?ON ·
U.S. v. Martinez Jr. Felony Adult Defendant ye * UTY
ll. OFFENSEQS] CHARGED (Cite U.S. Code, Title & Section) lf more than one offense, list (up to live) major offenses charged, according to severity of offense.
‘ 1) 18 922G.F -- UNLAVVFUL TRANSPORT/POSSESS/RECEWE FIREARMS THROUGH INTERSTATE COMMERCE
I2. ATTORNEY'S NAME élrirst Name, M.I., Last Nnme,lru:1uding any rniiix) I3. COURT ORDER
AND MAILING ADDR SS B 0 Appolnting Counsel E C Co—Cuunsel
`Njickcl-SOD, { [I F Subs For FederalDefender R Subs For Retained Attorney
111 Monroe, Su-iT' E P Subs Fer Paneiiutumey El Y Standby Counsel
Phoenlx Prior Attorneysliame.
Appalmrrient Dale: _____ '
E Because the above-named person represented has testified under oath or has
otherwise satislied this court that he or she [1] is linaneially unable tn employ counsel and
Telephone Number. 2 (2) does not wish to waive counsel, and because the interests ofjustioe so require, the
` attorney whose name appears in Item 12 is appointed to represent this person ln this use,
I4. NAME AND MAILING ADDRESS OF LAW FIRM(oniy provide per instructions) or
BURNS, D Other {See` ctio s)
Signature of Presiding Judiainl Hieer or y rder o he Court
8 Date of Order Nun: Pro Tunc Dale
Repayment or partial repayment ordered from the person represented for this service at
` 1 time of appointment. U YES ij NO
‘·i ir-
TOTAL MATHHECH MATHJTECH ADDITIONAL
C TEGORIES A n · · · r · wan is HOURS AMOUNT AD.TUS"l"ED ADJUSTED
A ( ttac itemization o services ates) CLAIMED CLAIMED HOURS AMOUNT RE`;-[EW
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19. CERTIFICATION OF ATTORNEYIPAYEE FDR THE PERIOD OF SERVICE zu. APPOINTMCENTTERMBQAHON DATE 21. CASE DISPOSITION
nv crime T1-IAN cAsE C0l'•rH’LE'l'ION
FROM MM TO _,,,,,,_,,,_,.,,_,_,.M
22. CLAIM STATUS Ki Final Payment Ci Interim Payment Number D Supplemental Payment _ V
Have you previously applied to the court for compensation and/or remirnbuuernent for this ease'? E YES I] NO lfyes, were you paid? I] YES EI 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
representation? D YES lj NQ Ifyes, give details an additional sheets. _
I swear or affirm the truth or correctness of the above statements. ‘
Signature offutomey: Date;

zz. IN COURT COMP. 24. OUT OF COURT COMP. _ 25. TRAVEL EXPENSES za. OTHER EXPENSES :7. TOTAL AMT. A1>1=1>.r CERT
za. SIGNATURE OF THE PRESIDING JUDICIAL OFFICER ' DATE 4 asa. .n.m<;E 1 MAG. JUDGE cone _
29. IN COURT COMP. _ 30. OUT OF COURT COMP. 31. TRAVEL EXPENSES 32. OTHER EXPENSES ss. TOTAL AMT. Aernovaa
34. SIGNATURE OF CHIEF JUDGE, COURT OF APPEALS (OR DELEGATE}P¤ymOém DATE » aaa. JUDGE CODE
IIppl'[l\'l·!d Ill EXCESS of (IN statutory IIIIYSIIDITI .lllI'IOUI'Ii. -
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Case 2:03-cr-00606-MHM

Document 55

Filed 02/16/2006

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