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


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Case 1 :08-cr—0001 5-G MS Document 22 Filed 07/31 /2008 g
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\C.lA 20 APPOINTMENT OF AND AUTHORITY TO PAY COURT APPOINTED COUNSEL (Rev. 5/99)
I. CtR.tDtST.t' DIV. CODE 2. PERSON REPRESENTE} VOUCHER NUMBER
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3. MAG pkt tors NtrMR¤¤ 4. DIST. r TJD F. NUMBER 5. APPEALS DKT/DEF NUMBER 6. OTHER DKT. NUMBER
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7. IN CASEIMATTER OF (Case Name) 8. PAYMENT CATEGORY 9. TYPE PERSON REPRESENTED I0. REPRESENTATION TYPE
MFeIony lj Petty Offense BfAdult Defendant I] Appellant (See Instruction:)
U J. ly ( A I] Misdemeanor [1 Other I] Juvenile Defendant lj Appellee
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I I OFFENSE(S) CHARGED (Cite U S Code, Title & Section) Umore than one ojense, list (up to _t‘7vEL_ mayor o_Je.nse.t· charged according to severity? 0 eru
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I2 ATTOR ’S NAME (First Name, MKII, Last ams, cnc/acting any i·u)?`tx), I3. OURT ORDER
AND MAILING ADDRESS O Appointing Counsel Et C Co—Counsel
B . _ { E <]"{___ F Subs For Federal Defender CI R Subs For Retained Attomey
T cb J. HA r I] P Subs For Panel Attorney El Y Standby Counsel
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B Prior Artomey's
QD. 13 I qq Appointment Dates:
M`] \LJ¤/I O G. Ii La E Q Q , 7 Q [I Because the above-named person represented has testified under oath or has otherwise
Telephone Number 02 ' satished this Coun that he or she (I ) is tinancially unable to employ counsel and (2) does not
wish to waive counsel, and because the interests ofjustiee so require, the attorney whose
I3 NAME AND MAIUNG ADDRESS OF LAW FtRM(0nIy·pmvtde per tn.v.tru.·:ttons) name appears in Item I2 is appointed to representt ' person in this ease, OR
[I Other (See lrutructtons)
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Repayment or partial repayment ordered from the person represented for this service at time
appointment. E] YES [I NO |
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TOTAL t·»tA1‘HJtECH. MA'I'H."'l`ECH.
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" " CLAJMED HOURS AMOUNT
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I9. CERTIFICATION OF AT'I`ORN'EYt'PAYEE FOR THE PERIOD OF SERVICE 20. APPOINTMENT TERMINATION DATE 2I. CASE DISPOSITION
O IF OTHER THAN CASE COMPI..E'I`ION I
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22. CLAIM STATUS El Final Payment U Interim Payment Number El Supplemental Payment
Have you previously applied to the court for eompensation andfor reimbursement for this El YES U NO Ifyes, were you paid? El YES EI NO
Other than from the Court, have you, or to your knowledge has anyone else, received paytnenfcompensarron or anything ofvolue) from any other source in connection with this
representation? D YES El NO lfyes, give details on additional sheets.
I swear or nflirm the tnith ur correctness ofthe above statements.
Signature of Attorney Date
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23 IN COURT COMP. 24 OUT OF COURT COMP. 25 TRAVEL EXPENSES 26. OTHER EXPENSES 27. TOTAL AMT. APPR./CERT
28. SIGNATURE OF THE PRESIDING JUDICIAL OFFICER DATE 28::. .lUDGEJ'MAG. JUDGE CODE
29 IN COURT COMP. 30. OUT OF OOURT COMP. 3I. TRAVEL EXPENSES 32, OTHER EXPENSES 33. TOTAL AMT. APPROVED
M SIGNATURE OF ct-ttEF JUDGE, COURT OF APPEALS (OR DELEGATE)P¤yraent approved DATE 34a. JUDGE CODE
rrr E.KC£fA'.i' ryfthe statutory thr¢¢.vh0t'n' amount , I .

Case 1:08-cr-00015-GMS

Document 22

Filed 07/31/2008

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