contract invoice by hZxpAYlJ


									                                                                                                                                       Revised May 2000
                                        OFFICE OF THE WISCONSIN STATE PUBLIC DEFENDER
                                                   ASSIGNED COUNSEL DIVISION
                                                    (For cases appointed commencing 7-1-00)

                                                    CONTRACT CASE INVOICE
Type or Print Legibly
SPD File Number                                                              Lead Attorney Name

Client Name                                                                  Lead Atty. State Bar #

Case County

Date Appointed                                                               Date Case Closed

    Lead Attorney
Adjunct Attorney Name                                                        State Bar #
       Total Contract Rate per Case                                                                $
       Total Contract Expenses (experts, investigators, discovery)                                 $                                         Attach
       itemized bills and request forms (as other pertinent information). List expenses hereunder:

       TOTAL PAYMENT REQUESTED:                                                                                $
           I, the assigned attorney, do hereby certify the following: (1) the information recorded on this case invoice is true and correct; (2) I am an
approved contract lead or adjunct attorney; (3) I am the attorney who did the case work; (4) during the time work was performed, I held a valid
license to practice law in WI; and (5) during this calendar year, I will have completed six (6) hours of continuing legal education in courses approved
by the State Public Defender.

I further certify, if applicable:                                                       SEND TO ASSIGNED COUNSEL DIVISION:
     I withdrew from this case prior to final disposition.                                            (stapled in order)
     I was privately retained on this case prior to SPD appointment.                        1. Contract Case Invoice
                                                                                            2. Time Sheets
                                                                                            3. Other Pertinent Information
____________________________________________                                                   (e.g., itemized bills, approved request forms)
Assigned Attorney Signature         Date                                                    4. Order Appointing Counsel
                                                                                            5. Case Closing Memorandum

Lead Attorney Signature             Date                                                SEND TO LOCAL SPD (APPOINTING) OFFICE:
(indicates review & approval of case work & invoice)                                          Copy of Case Closing Memorandum

Do not write below line. For SPD use only.

         Assigned Counsel Division Date Stamp
                                                                                                                Audit Stamp

                                                   ASSIGNED COUNSEL DIVISION

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