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

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2:04-006048-001 2:04-000176-001 A
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U. S. v. Joaquin Felony Adult Defendant F %|§ I ‘ L Ee _·
ll. 0FFE.NSE{S) CHARGED (Cite U.S. Code, Title & Section) lf more than one offense, list (up lu tive) major offenses ch
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I2. A'I'l`ORNEY‘S NAME éliirst Name, M.I., Last Name, including any sufhs) I3. COURT ORDER
A-ND MAILING ADDR SS B O Appointing Counsel D C C0·Couusel
INIGUEZ BALTAZAR D F sion no- mimi Defender EI It snin an annnns nnnmsy
3 N I] P Subs For P&nelAttnrney El Y Standby Counsel
PHOENIX AZ 8 5016 ""*°' ·“‘”°""°l"' ""'“‘
Appointmnt Date: ,_,,,___,_,________
I;] Because the above-named person represented has testitied under oath or has
otherwise satistiad this oourt that he or she (I} ls flnaoelally nnahle to employ counsel and
Tcmpnm Numhm E (2) dau not wish to waive counsel, and because the interests otjnstice so require, the
attorney whose name app ’ 1 ·. ri represent this in this ease,
14. NAME AND MAILING ADDRESS OF LAW FIRM(only provide per instructions) or .·
El Other (See Ins ons) {
Signature ¤fI’residing Judicial Oflicer or By Order ofthe Court
—..........i...
Date of Order Nun: Pro Tune Date
Repayment or partial repayment ordued from the person repruentaed for this service at
time of appointment. D YES I] NO
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19. CERTIFICATION OF ATTORNEYIPAYEE FOR THE PERIOD OF SERVICE 20. A.m>01N‘r1·vutNr TER.lVEl'NATION mm 21. CASE DISPOSITION
FROM TD IF OTHER THAN CASE C0l\·1`PLE'I`ION
22. CLAIM STATUS El Flnal Payment D Interim Payment Number I] Supplemental Payment
Have you previously applied tothe court for compensation aadlor resnluthnraesnent for thla case? I:] YES [I NO Ifyes, were you paid? I] YES I] N0
Other than from the court, have yon, or to yo r lcnowled e has anyone else, received payment (compensation or anything or value} from any other source In eonneetion with this
representation? El YES I] N0 Ify ». gE·e details on additional sheets. V
I swear or aflirm the truth or correctness of the above statements.
Signature ofA¤0l1l8}'t _ .,.,.,,,_ - ` ,,.,1.- _,_. _, Date:
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approved In excess ofthe statutory threshold amount.
Case 2 :04-cr-001 76-RGS Document 65 Filed O7/14/2006 Page 1 of 1

Case 2:04-cr-00176-RGS

Document 65

Filed 07/14/2006

Page 1 of 1