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					      UNITED STATES DISTRICT COURT
          DISTRICT OF WYOMING
CJA WORKSHEETS - CAPITAL REPRESENTATIONS
                 CJA 30
 To start the billing process, please complete the following information:


 Case Number:
 Case Name:
 Defendant:
 District Judge:

                                      Appointed Attorney
 Full Name:
 Firm Name:
 Street or PO Box:
 City, State, ZIP:
 Phone#:
 Fax#:
 E-mail:
 Type:
    CJA 30 Worksheet -- Attorney Hours
     Attorney:
    Defendant:
     Case No:
        Judge:
                        Voucher categories:    15.a.        15.b.        15.c.           15.d.          15.e.        15.f.        15.g.          15.h.       15.i.    15.j.
                                                          Interviews                  Consultation    Obtaining &  Obtaining/
                                                              and                         with        Reviewing    Reviewing    Consulting       Legal
                                              In-Court   Conferences    Witness       Investigators    the Court  Documents &   with Expert   Research and
      Date            Description             Hearings     w/ Client   Interviews       & Experts       Record      Evidence     Counsel        Writing      Travel   Other




7/22/2010                                                               Page 2 of 6
       CJA 30 Worksheet - Travel Expenses
     Attorney:
    Defendant:
     Case No:
        Judge:

                                                 Parking/
                                                  Tolls/                                                       Other
                                        Travel    Public                            Taxi/                     Travel
      Date       Expense Description   mileage    Trans     Airfare   Rental Car   Shuttle   Hotel   Meals   Expenses




7/22/2010                                         Page 3 of 6
                    CJA 30 Worksheet - Expenses
             Attorney:
            Defendant:
             Case No:
                Judge:

                                                                  Long
                                                                 Distance                             Other
             Date         Expense Description     Facsimile      Charges    Photocopies   Postage   Expenses




7/22/2010                                          Page 4 of 6
                                                              CJA 30 - Voucher Summary
              Attorney: 0
                                                                Any errors on this page were created by
         Defendant: 0
                                                              entries on the previous four pages. Correct
  Dist. Ct. Case No: 0                                       the prior page and it will automatically fix this
     Dist. Ct. Judge: 0



                                                         1/1/2010 - current            3/11/2009 - 12/31/09          1/1/2008 - 3/10/2009    5/20/07 - 12/31/07
                            Rate                              $178.00                       $175.00                       $170.00                  $166.00
                                                       Hours           Court           Hours       Court             Hours       Court       Hours         Court
                       Categories
                                                      Claimed        Adjustment       Claimed   Adjustment          Claimed   Adjustment    Claimed     Adjustment
15a - In-Court hearings                                          -                -              -              -              -        -          -                -
15b - Interviews & conferences w/ client                         -                -              -              -              -        -          -                -
15c - Witness interviews                                         -                -              -              -              -        -          -                -
15d - Consultation w/ investigators and experts                  -                -              -              -              -        -          -                -
15e - Obtaining and reviewing court record                       -                -              -              -              -        -          -                -
15f - Obtaining/reviewing documents & evidence                   -                -              -              -              -        -          -                -
15g - Consulting w/ expert counsel                               -                -              -              -              -        -          -                -
15h - Legal research and writing                                 -                -              -              -              -        -          -                -
15i - Travel                                                     -                -              -              -              -        -          -                -
15.j. Other                                                      -                -              -              -              -        -          -                -
Total 15a - 15j (Hours)                                          -                -              -              -              -        -          -                -
Total hours x rate per hour                                      -                -              -              -              -        -          -                -




17. Travel Miles                                      1/1/2010 -     2/1/2009 -       8/1/2008 -     3/19/2008 -    2/1/2007 -
                                                       current       12/31/2009       1/31/2009       7/31/2008     3/18/2008

                                     Rate per mile:        0.500          0.550           0.585           0.505         0.485
Total Miles Claimed                                          -                -              -              -              -
Miles Adjusted                                               -                -              -              -              -
Total Adjusted Mileage x Rate Per Mile                       -                -              -              -              -

                                                        Atty         Court Adj.         Total
                                                      Request         (if any)        Approved
17. Travel Miscellaneous                                     -                -              -
17. Total Travel Expenses                                    -                -              -
18. Facsimile                                                -                -              -
18. Long Distance Charges                                    -                -              -
18. Photo Copies                                             -                -              -
18. Postage                                                  -                -              -
18. Other Expenses                                           -                -              -
18. Total Other Expenses                                     -                -              -


Amounts transferred to voucher:                              -                -              -




   7/22/2010                                                              Page 5 of 6                                                              Revised 8-2009
   CJA 30 (Electronic Form) DEATH PENALTY PROCEEDINGS: APPOINTMENT OF AND AUTHORITY TO PAY COURT APPOINTED COUNSEL (Rev. 5/99)
1. CIR./ DIST./ DIV. CODE               2. PERSON REPRESENTED                                                  VOUCHER NUMBER
WYX
3. MAG. DKT./ DEF. NUMBER                     3. DIST. DKT./ DEF. NUMBER               3. APPEALS DKT./ DEF. NUMBER                                6. OTHER DKT. NUMBER

7. IN CASE/MATTER OF (Case Name )                              8. TYPE PERSON REPRESENTED                                  9. REPRESENTATION TYPE

10. OFFENSE(S) CHARGED (Cite U.S. Code, Title & Section) If more than one offense, list (up to five) major offenses charged, according to severity of offense.


11. ATTORNEY'S NAME (First Name, M.I., Last Name, including any suffix),
AND MAILING ADDRESS:                                                          12. COURT ORDER:
Name:
                                                                                                     Prior Attorney's                                               Appointment
Address:                                                                      (A) Because the above-named person represented has testified under oath or has otherwise satisfied this
                                                                              Court that he or she (1) is financially unable to employ counsel and (2) does not wish to waive counsel, and
                                                                              because the interests of justice so require, the attorney whose name appears in Item 11, who has been
                                                                              determined to possess the specific qualifications by law, is appointed to represent the person in this case.
Phone:                                                                        (b) The attorney named in Item 11 is appointed to serve               Lead Counsel            Co-Counsel
E-mail:
                                                                                      Name of Co-Counsel or Lead Counsel                                            Appointment

13. NAME AND ADDRESS OF LAW FIRM                                              (C) If you represented the defendant or petitioner in any prior proceeding related to this matter, attach to your
   (Only provide per instructions)                                            initial claim a listing of those proceedings and describe your role in each (e.g., lead in counsel or co-counsel).
                                                                                         (D) Due to the expected length of this case, and the anticipated hardship on counsel in
                                                                              undertaking representation full-time, for such a period without compensation, interim payments of
Name:                                                                         compensation and expenses are approved pursuant the attached order.


Address:                                                                                      Signature of presiding Judicial Officer or By Order of the Court

                                                                                               Date of Order                               Nunc Pro Tunc Date
                                                                              (E) Repayment or partial repayment ordered from the person represented for this service at time of
                                                                              appointment.                Yes                No
                                                                     CLAIM FOR SERVICES AND EXPENSES
14. STAGE OF PROCEEDING Select the stage which corresponds to the stage of the proceeding during which the work claimed at Item 15 was performed even if the work
is intended to be used in connection with a later stage in the proceeding. SELECT NO MORE THAN ONE STAGE. Submit a separate voucher for each stage of the proceeding.
CAPITAL PROSECUTION:                                             HABEAS CORPUS:                                   OTHER PROCEEDING:




                                     HOURS AND COMPENSATION CLAIMED                                                                           FOR COURT USE ONLY
                                                                                                                              MATH/TECH
15. Categories (Attach itemized time & expense sheets with           HOURS                                                    ADJUSTED                MATH/TECH               ADDITIONAL
dates)                                                              CLAIMED               TOTAL AMOUNT CLAIMED                 HOURS               ADJUSTED AMOUNT             REVIEW
  a. In-Court hearings                         -    -                                                                -                                 IN COURT                 IN COURT
  b. Interviews and Conferences with Client         -                                                                -                                   TOTAL                    TOTAL
  c. Witness Interviews                             -                                                                -                                 Category a              Category a
  d. Consultation with Investigators & Experts      -                                                                -
  e. Obtaining & Reviewing the Court Record         -                                                                -
  f. Obtaining & Reviewing Documents & Evidence     -                                                                -                               OUT OF COURT           OUT OF COURT
  g. Consulting with Expert Counsel                 -                                                                -                                   TOTAL                    TOTAL
  h. Legal Research & Writing                       -                                                                -                                Categories b-j          Categories b-j
  i. Travel                                         -                                                                -
  j. Other (Specify on additional sheets)           -                                                                -
TOTALS: Categories b thru j                    -    -                                                                -                    -
CLAIM FOR TRAVEL AND EXPENSES (Attach Expense Sheet with Dates)
16. Travel Expenses (lodging, parking, meals, mileage, etc.)                                                         -
17. Other Expenses (other than expert, transcripts, etc.)                                                            -
GRAND TOTALS (CLAIMED AND ADJUSTED):
18. CERTIFICATION OF ATTORNEY/PAYEE FOR THE PERIOD OF SERVICE                          19. APPOINTMENT TERMINATION                                 20. CASE DISPOSITION
From:                                 to:                                                  DATE IF OTHER THAN
                                                                                           CASE COMPLETION:
21. CLAIM STATUS:                    Final Payment                     Interim Payment Number                                            Supplemental Payment

 Have you previously applied to the court for compensation and/or
                                                                               Yes              No                              If yes, were you paid?        Yes               No
reimbursement for this case?
Other than from the court, to your knowledge has anyone else, received payment (compensation or anything of value)
from any other source in connection with this representation?                                                               Yes               No      If yes, give details on additional sheets.
I swear or affirm the truth or correctness of the above statements.
Signature of Attorney:                                                                                                                                    Date
                                                                    APPROVED FOR PAYMENT--COURT USE ONLY
22. IN COURT COMP.              23. OUT OF COURT COMP          24. TRAVEL EXPENSES                       25. OTHER EXPENSES                        26. TOTAL EXPENSES

27. SIGNATURE OF THE PRESIDING JUDICIAL OFFICER                                                          DATE                                      27a. JUDGE CODE

				
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Description: Petition the Court Legal Forms document sample