Form Opd-1031 - Application For Attorney Fees For Court Appointed Attorneys Page 2
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3SUPREME COURT OF OHIO
MOTION, ENTRY, AND CERTIFICATION FOR APPOINTED COUNSEL FEES
State of Ohio,
Supreme Court No. ______________________
Plaintiff
Appeals Court No. _______________________
V.
Trial Court No. __________________________
____________________________________________
Defendant
MOTION FOR APPROVAL OF PAYMENT OF APPOINTED COUNSEL FEES AND EXPENSES
The undersigned, having been previously appointed counsel for the defendant for the appeal to this court, as
evidenced by the attached entry of appointment, now moves for an order approving payment of fees earned and
expenses incurred as reflected by the itemized statement of the reverse hereof, pursuant to R.C. 2941.51.
IN COURT
OUT OF COURT
Hours Worked:
Expenses (if any): $
O.R.C. charge section number, name and classification
A.
B.
C.
SUPREME COURT DECISION
TERMINATION DATE
ATTORNEY’S NAME
SOC. SEC. NO.
ATTORNEY’S SIGNATURE
ATTORNEY’S ADDRESS
NUMBER AND STREET
CITY
STATE
ZIP
INFORMATION BELOW TO BE COMPLETED BY SUPREME COURT AND COUNTY AUDITOR ONLY
JUDGMENT ENTRY
This court finds that counsel performed the legal services set forth in the itemized statement on the reverse hereof,
and that the fees and expenses hereinafter approved are reasonable. IT IS THEREFORE ORDERED that appointed
counsel fees are approved in the sum of $ ___________________________ and expense in the sum of
$___________________________ for a total allowance of $____________________________, which amount is
ordered certified to the ____________________________ County Auditor for payment.
________________________________________
CHIEF JUSTICE
CERTIFICATION
The County Auditor, in executing this certification, attests to the accuracy of the figures contained herein.
A
subsequent audit by the Ohio Public Defender Commission and/or Auditor of the State which reveals unallowable or
excessive costs may result in future adjustments against reimbursement or repayment of audit exceptions to the Ohio
Public Defender Commission.
COUNTY NUMBER
WARRANT NUMBER
WARRANT DATE
COUNTY AUDITOR
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