Free CJA 20 - Appointment - District Court of Arizona - Arizona

_ CJA 20 APPOINTMENT OF AND AUTHORITY TO PAY COURT APPDINTED COUNSEL
1. CIRJDISTJDIV. CODE 2. PERSON REPRESENTED VOUCHER NUMBER
AZX Wirth Jr., Robert Wayne __ D D
3. MAG. DKTJDEF. NUMBER 4. DIST. DKTJDEF. NUMBER 5. APPEALS DKT./DEF, NUMBER 6. BTHERLIEQ`. NUMBER » LO G
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· 2:04-050185-001 E _ ""_ _ _ D Y
7. IN CASE/MATTER OF u:IIIIe Name} 8. PAYMENT CATEGORY 9. TYPE PERSON REPRESENTED 10. IEDPIDIESENTRATION TY'P‘E"
U.S. v. Wirth Jr. Other Adult Defendant Superv` _•i ' · lg; _ _ _ _
II. OFFENSEIS} CHARGED (Cite U.S. Code, Title SI Section) Ifmore :II»II IIIIIe II1r¤I»e, a.n4IIp TII Eve) Illllllf IIneII¤¤ eIIIII-gui, emmmgu mersry IIr enema ‘ : l I
CLERK U 3 DISTRICT C ` rw
E ~ " E S * -1 _ I cl
12. A'I'I`0RNEY'S NAME . ., I I in 13. COURT ORDER ·
AND MAILING .lIII>I¤I§?§‘"“'“°‘“' L"' "'°'“" "°"""‘”"""‘““ " 0 II,,,...I..r...,c......n E Fle ury
F .'iuhsForFed¤·alDefender ‘ I"’¤T~>· F'- W- ‘ ~ ··- ..
5 S, El P Subs For Panel Attorney I] Y Standby Counsel
1833 E. Baseline Road M" "'°°f"°’°’ "‘“"°’ —
Gilbert AZ 85233-1545 ·*PP¤¤¤¤¤¤·¢ ¤¤¢== —-———-—-—
Cl Been lh h ed person represented has testitied mler oath rhas .
oIlIeI·I·rIseL:t¢tisfl;¢= tit`:. that he or she {I) is Iinancially unable to emplgy counsel and
. 480 892-7] 77 (2) does not wish to waive counsel, and because the interests ofjustlee so require, the
Telephone Numbm attomey whose name n ral ni I2 is poin n repruent thi; penon In this use
I4. NAME AND MAILING ADDRESS DF LAW FIRM{only provide per instructions) or mm. I
ANNE M. VVILLIAMS PC D °"‘°"S°° '“”'““ "’) ·
5 - Signature of Presiding Judi: al fficcr or By Order ofthe Court
1833 E. Baselme Road D5 [D] QDO6
G1lb€1°t AZ Date o|'0rder Nun: Pro Tom: Date
Repayment or parthl repayrlriqt ugdwui lf§oml:.‘I5 person represented for t.I1h servloe at W
time of appointment. E
HOD-DS TOTAL Iv1ATHrI‘ECI·I MAT]-L'TECH ADDITIONAL
CATEGORIES (Attach Iteml »= tlon of services with dates) ’ CLAIMED AI?-I.Ig'§%D REVIEW
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19. CERTIFICATION OF A'I'l`ORNEY/'PAYEE FDR THE PERIOD OF SERVICE 211. APPOTNTMENT TERNIDJATIDN DATE 21. CASE DISPOSITION
IF orrnzn 'I'I·lAN CASE COMPLETION
FROM TO
ZZ. CLAIM STATUS [I Fmal Payment EI lnterlm Payment Number I:] Supplemental Payment
Have you previously applied to the court [or oontpensation and/or remlmbursement for this case? EI YES III NO II yes, were you paid? I] YES Ki NO
Other than from the court, have yon, or to your knowledge has anyone else, received payment (compensation or anything or value) from any other source In connection with this
rqiresentatlon? I] YES I] NQ Ifyu. grve details on additional sheets.
I swear or afllrm the truth or correctness of the above statements.
Signature of Attorney: , ___,, ,,, , , , , ,, Date:
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23. IN COURT COMP. 24. OUT OF COURT COMP. 25. TRAVEL EXPENSES 26. OTHER EXPENSES 21. TOTAL AMT. APPR} CERT
28. SIGNATURE OF THE PRESIDING JUDICIAL OFFICER DATE zse. .r1m•:mMAc. Tuner conn
29. IN COURT COMP. 30. OUT OF COURT COM P. 31. TRAVEL EXPENSES 32. OTHER EXPENSES 13. TOTAL Am. APPROVED
34. SIGNATURE OF CHIEF JUDGE, COURT OF APPEALS (OR DELEGATE}PIIyIIIeIIr DATE 34a. JUDGE CODE
approved ln excess ofthe statutory threshold amount.
Case 2 :04-cr-501 85-FJ I\/I Docu ment 29 Filed 05/08/2006 Page 1 of 1

Case 2:04-cr-50185-FJM

Document 29

Filed 05/08/2006

Page 1 of 1