Order Approving Payment Of Appointed Counsel Fees And Expenses
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1
2FOR JUDICIAL USE ONLY
PDS USE ONLY
Reason for Appointment (Check One):
INVOICE NUMBER
________ Conflict in Public Defender Office
________ No Public Defender Office
________ Case Overload in Public Defender Office
________ Other
IN THE CIRCUIT COURT OF
COUNTY
STATE OF WEST VIRGINIA
CASE NUMBER(S)
_______________________
_____
VS.
__________________________
_________________________________
_____________________________
ORDER APPROVING PAYMENT OF
APPOINTED COUNSEL FEES AND EXPENSES
On a former date an affidavit was filed in this Court reciting that ___________________________
was financially unable to employ counsel for representation in certain proceedings before this Court;
and the Court being of the opinion the eligibility requirements of W.Va. Code § 29-21-1, et seq, were
satisfied appointed ______________
____ a licensed Attorney at Law practicing
before the Bar of this Court as counsel.
Counsel informs this Court these proceedings have been completed, and has tendered to the Court a
defense counsel voucher indicating the services performed and the expenses incurred in connection with
the representation of this client. This Court has inspected said voucher and accompanying
documentation and does hereby approve a payment of: $__________________ for services of counsel
and for expenses incurred in connection with the representation; which amount shall be recorded by the
Circuit Clerk a part of the costs of these proceedings.
Accordingly it is HEREBY ORDERED:
(1)
That the Clerk forward to Public Defender Services two certified copies of this Order together
with two copies of the defense counsel voucher and all attachments;
(2)
That Public Defender Services issue payment in the appropriate amount, at whatever time as
funds may become available, whether in the current or succeeding fiscal years, and subject to statutory
limits, to:
, _____
Payee Name
Tax Identification Number
_______________________________________________________________________
Payee Mailing Address
ENTER THIS
,
DAY OF
, __________
(day)
(month)
(year)
_________________________________________________
JUDGE
IMPORTANT NOTE: All required orders of court must be certified copies and must bear the Circuit Clerk’s seal.
Revised July 2009
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