Form E1701 - Motion, Entry, And Certification For Appointed Counsel Fees - 2015
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MOTION, ENTRY, AND CERTIFICATION FOR APPOINTED COUNSEL FEES
Juvenile
Franklin County
In the _________________________________________
Court of ________________________________________, Ohio
Plaintiff:
Case No. _________________________________________
Appellate Case No. (if app.) ___________________________
v.
_________________________________________________
Capital Offense Case (check if Capital Offense case)
Defendant/Party Represented
Guardian Ad Litem (check if appointed as GAL)
In re: _____________________________________________
Judge: ___________________________________________
MOTION FOR APPROVAL OF PAYMENT OF APPOINTED COUNSEL FEES AND EXPENSES
The undersigned having been appointed counsel for the party repres
ted moves this Court for an order appro ing payment of fee
and expenses as ind icated in the itemized statement herein. I certify that I have received no compensation in conn ction with
providing representation in t his case other than that des cribed in this motion or which has been approved by the Court in a previous
motion, nor have any fees and ex penses in this motion been duplicated on any other motion. I, o an attorney under my supervision,
have performed all legal services itemized in this motion.
Periodic Billing (check if this is a periodic bill)
As attorney/guardian ad litem of record, I was appointed on ______________________ ________. This case terminated and/or was
disposed of on ______________________ ________. I am submitting this application on _________________________ ________.
Name_____________________________________________ Signature________________________________________________
____________________
Address___________________________________________________________________
No. and Street
City
State
Zip
OSC Reg. No. ________________
SUMMARY OF CHARGES, HOURS, EXPENSES, AND BILLING
OFFENSE/CHARGE/MATTER
ORC/CITY CODE
DEGREE
DISPOSITION
1.)
2.)
3.)
*List only the three most serious charges beginning with the one of greatest severity and continuing in descending order.
IN-COURT
PRE-TRIAL
ALL OTHER
Grand Total Hours
HEARINGS
IN-COURT
OUT-OF-COURT
IN-COURT TOTAL
GRAND TOTAL
From Other Side:
0.0
0.0
0.0
0.0
0.0
0.0
$60.00
$0.00
$0.00
Flat Fee
Hrs:In
__________
X Rate ________
= $_____________
Tot. Fees $___________
0.0
$50.00
$0.00
$0.00
$0.00
Min Fee
Hrs:Out __________
X Rate ________
= $_____________
Expenses $___________
Total $___________
JUDGMENT ENTRY
The Court finds that counsel performed the legal service s set forth on the itemized statement on the reverse hereof, and that t he fees
and expenses set forth on this statement are reasonable, and are in accordance with the resolution of the Board of Count
Franklin County
Commissioners of _________________
_________________, Ohio relating to payment of appointed coun
l, that all rules and
standards of the Ohio Public Defender Commission and State Public Defender have been met.
IT IS THEREFORE ORDERED that counsel fees and expenses be, and are hereby approved, in the amount of $________________.
It is further ordered that the said amount be, and hereby is, certified by the Court to the County Auditor for payment.
Signature Page Attached
Judge ______________________________________________
Extraordinary fees granted (copy of journal entry attached)
Signature
Date
CERTIFICATION
The County Auditor, in e xecuting this certification, attests to the accuracy of the figures contained herein. A subsequent audit by the
Ohio Public Defender Commission and/
Auditor of t e State which reveals una lowable or e cessive costs may result in future
adjustments against reimbursement or repayment of audit exceptions to the Ohio Public Defender Commission.
25
County Number ___________________
Warrant Number ___________________
Warrant Date ___________________
County Auditor
____________________________________________________
(e1701 1-2015)
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