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

<=-155515*551-*55* APPOINTMENT OF AND AUTHORITY TO PAY COURT APPOINTED COUNSEL
1. JURISDICTION . . . . . . . .. .
( _ ( _ 3 [E APPEALS _ 2 MAG DOCKET NO 3 DIST cr DOCKET no vcucnen NO 1- O 1 1 5 2 3
1 El MAe. 2 D mst 4 El OTHER_____________, _ CR-04-319-PHX-S '· ¤ .
4. APPEALS DOCKET No. s. 1=on 4o1sTn1cTl·01n0u1r) s. 1.00. 001:le 1. 01-1AnoEl·o1=1=ENsE (us. or other code ¤11a11¤l11 TA. oAsE 0ooE
05-10364 Ninth Circuit CAUSF i APPEAL lf ··——-——-—~ _
s. IN THE CASE or ( 9. Penson nEpnEse1vTEo (r=ur.1. NA - 1 4 sA. {:2; ED
U . S . vs SEPULVEDA-URIBE ABELABDO SEPULVEDA-U ’ I RECEiV5¤;) l .,,,.,
10. PERSON REFFIESENTED (srATus1 11. 1=nocEEo1l~1csgoes¤r1oe ¤l·1er1y) ’ `
1 El DEFENDANT-ADULT s K] APPELLANT rl U OTHER NO V
2 1] DEFENDANT-JUVENILE 4 [I ,¤.l=·l=•El,1,ee ________ Appeal ( ]_ 2I][]5
12. PAYMENT cATseonv \
A El 1=E1.o1~1v 0 El PETTY OFFENSE E [I OTHER CI·I?_I?I€ U ti ITIS? Tongs {-tm W V
5 I] Mlspgmemon n [X APPEAL __________________ _ HIS .';i;{5I £_,_s d`»` ,;_ , if ’ ‘·
13. COURT onoen 14. FULL NAME OF ATTOR F 15AÂ¥eE(e1rs_1 Nemo, MJ., Last
0 IK} ADPOIRIIHQ ollllllssl 15 El SLIbS.10r 1=o ’ t¤¤l¤¤l¤e S¤tfl> C El Co—GcunseI R [I Subs. for Retained Atty. Gail Ngtglg, Esq, —"
P I3 Subs. for Panel Atty.
_ Name of prior panel attorney Sl 7 N' Seccnd Street
I Phoenix, AZ 85004
Appl. Date Voucher No.
15. WORK PHONE 16A. Does the attorney have the preexisting agree-
ment (see Instructions) with e corporation,
Because the above-named "person represented" has testilled under oath or has _ O2_258_1 7 78 I¤¤I¤dll'*Q 8 P¤'¤*¤¤¤|¤¤¤I ¤¤•'P¤l'¤II¤¤?
otherwise satlslled this court that he or she (1) ls financially unable to employ counsel EI Yes I] No
_ and (2) does not wish to waive counsel, and because the interests of iuslice so require, 16B_ OCIAL SECURITY NO_ 16C_ MPLOY R ‘_D_ NO_
the attorney whose name appears ln item 14 Is ap olnted to represent this person in &>nty provide per Instructions) EJnly progde per rnstmotionsj
this case.
. 1so. NAME Ann MAILING ADDRESS on r.Aw FIRM
P (Only provlde per Instructions)
Sig. ot Presiding Judiclal Officer or By Order of rt (ClerIr.lDeputy)
U- [O Q DB r- Oct. 25, 2005 same as #14 .
Date of Order Nunc Pro Tum: Date
CLAIM FOR SERVICES OR EXPENSES
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5 5- 51511555 55=15¤¤5 55*5 *5*5* 55*55-
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s 5- ·¤5555·¤5·*~·5 555 55551 W5 1555555 55 555-5555* 5555551
I ° 55555 ¤55 55··1= 155555 5·¤¤55= 5
19. TRAVEL, LODGING, MEA1.s Erc. AMOUNT ornen expenses .. . AMOUNT 1sA. TOTAL TRAVEL Exn
I 5
I A __ *55- T°“5 °T*'E'* 5***
~ Cf)
LI'.!
2 ____ 5
S __ 2°· GMD TOTAL
w _ GLMMED
5
21. CERTIFICATION on ATFORNEYIPAYEE FOR PERIOD
F III Final Payment I EI Interlm Payment No. Has compensation andlor reimbursement for work in this case previously been applied for? I] YES E N0
lf yes, were you paid? I] YES I] NO lf yes, by whom where you paid? ______ How much‘?_____ Has the person represented pald any
money to you, or to your knowledge to anyone etse, In connection with the matter for which you were appointed to provide representatlon? [I YES CI NO
lf yes, glve detalls on additional sheets. __.....
I swear or afllrm the truth or correctness of the above statements V >
SIGNATURE o1= ATTORNEYIPAYEE one
22. IN counr coMn zz. our OF oounr COMP. 24. TRAVEL expense 25. OTHER Expenses ze. TOTAL AMT.
· Anneovtoroenr.
DE s s s s s
E E 21. SIGNATURE OF nnesromc JUDICIAL OFFICER . DATE 2rA. .1uooE1MAe. —
2 ai oooE
CL D.
E S 212.5 SIGNATURE or= c1—111z1= Juoee, ct OF A1=1=1aA1.s (on DELEGATE) I DATE 29. TOTAL AMT.
ll. .*~·- APPROVED
CaS92ZO - H - I3 I• n-n 4 -• I Q!. 'see s 5
omslmel. - FIETAINED ev FIWGEAL DEPLFEY CLERK I · ‘· - 5 -

Case 2:04-cr-00319-SRB

Document 114

Filed 11/01/2005

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