Motion, Entry, And Certification For Appointed Counsel Fees

MOTION, ENTRY, AND CERTIFICATION FOR APPOINTED COUNSEL FEES

In the _________________________________________

Court of ________________________________________, Ohio

Plaintiff:

Case No. _________________________________________

Appellate Case No. (if app.) ___________________________

_________________________________________________

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 represented moves this Court for an order approving payment of fees

and expenses as indicated in the itemized statement herein. I certify that I have received no compensation in connection with

providing representation in this case other than that described in this motion or which has been approved by the Court in a previous

motion, nor have any fees and expenses in this motion been duplicated on any other motion. I, or 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________________________________________________

SSN/Tax ID____________________

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

OUT-OF-COURT

HEARINGS

IN-COURT

IN-COURT TOTAL

GRAND TOTAL

From Other Side:

Flat Fee

Hrs:In

__________

X Rate ________

= $_____________

Tot. Fees $___________

Min Fee

Hrs:Out __________

X Rate ________

= $_____________

Expenses $___________

Total $___________

JUDGMENT ENTRY

The Court finds that counsel performed the legal services set forth on the itemized statement on the reverse hereof, and that the fees

and expenses set forth on this statement are reasonable, and are in accordance with the resolution of the Board of County

Commissioners of ______________________________ County, Ohio relating to payment of appointed counsel, 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.

Extraordinary fees granted (copy of journal entry attached)

Judge ______________________________________________

Signature

Date

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

____________________________________________________

Motion, Entry, And Certification For Appointed Counsel Fees - Ohio Court

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