Free Form - Michigan

STATE OF MICHIGAN CIRCUIT COURT FOR THE COUNTY OF MACOMB PEOPLE OF THE STATE OF MICHIGAN

REQUEST FOR PAYMENT OF COURT APPOINTED ATTORNEY FEES v
Defendant Name

Circuit Ct. Case No. District Ct. Case No. Judicial Aide Acct. No.

Attorney Name

Bar No.

Tax I.D. No.

Street Address

Phone Number

Fax Number

City, State, Zip

Date of Appointment

Macomb County Vendor No.

Charge(s)/Type of Case

Client Name

Sentence (Date, Type)

I was appointed to represent the defendant in this action. I hereby request payment for the following services pursuant to the indigent fee schedule. (If your request is for simultaneous services in separate case numbers, check the following appropriate blank and reduce the amount requested accordingly. Use a separate form for each case). ` 2nd simultaneous case (reduce fees by 50%). ` 3rd simultaneous case (reduce fees by 75%). 4th or more simultaneous case, no additional compensation.
DATE(S) OF SERVICE FEES

` Adjournment of event not attributable to defense
counsel $50.00

` Lineup (In Macomb, $50.00, Out, $100.00) ` Initial Preparation $100.00 ` Waiver of Preliminary Exam $50.00 ` Plea or dismissal instead of preliminary examination $100.00 ` Preliminary Exam
Half-Day days x $100.00 Full Day days x $150.00 ` Waiver of Circuit Court Arraignment $50.00

` Circuit Court Arraignment/First Conference $100.00 ` Pretrial Conference $75.00 ` Appearance Resulting in Remand to District Ct. $50.00 ` Preparation of Motion for Wade or Walker Hearing $25.00 ` Preparation of Motion Requiring Research $100.00 (specify type)

STATE OF MICHIGAN CIRCUIT COURT FOR THE COUNTY OF MACOMB

REQUEST FOR PAYMENT OF COURT APPOINTED ATTORNEY FEES

Circuit Ct. Case No. District Ct. Case No. Judicial Aide Acct. No.
FEES

DATE(S) OF SERVICE

` Oral Argument on Motion $75.00 ` Evidentiary Hearing
Half-Days x $100.00

` Guilty Plea (Circuit Court) $250.00 ` Circuit Court Trial
Capital (FC) Cases Non-Capital (FH) Cases days x $450.00 days x $300.00

` Advisory or Paternity Trial Counsel
Half-Days x $100.00 Full Days x $200.00

` Preparation of Motion for HYTA $25.00 ` Sentence on Date of Plea $50.00 ` Sentence on Subsequent Date $100.00 ` Sentence Review Hearing $50.00 ` Probation Violation Proceeding $75.00 ` Domestic Hearing $100.00 ` Extradition Proceedings ` Other Services
hours x $25.00

hours x $25.00 (Attach itemized Statement) ` I seek compensation for extraordinary services for the reasons set forth in detail in the attached statement TOTAL FEES REQUESTED I understand that payment for extraordinary services is discretionary and may only be available by written motion before the Judge assigned to the case. I have not received compensation from any source in handling this case. I have no expectation of receiving, nor will I accept, any other compensation. I accept the above requested fees as the full and complete payment for services rendered to date in this case. VERIFICATION UNDER MCR 2.114: I declare that the statements above are true to the best of my information, knowledge and belief.

Signature of Attorney

Date

A COPY OF THE NOTICE OF APPOINTMENT MUST BE ATTACHED. FORWARD BILLING TO: OFFICE OF THE JUDICIAL AIDE, MACOMB COUNTY COURT BUILDING, 40 N. MAIN, MOUNT CLEMENS, MI 48043