|Item 1.||CIR./DIST./DIV. CODE: This six-character location code is the circuit, district, and divisional office codes of the court where the proceedings for the person represented are held.|
|Item 2.||PERSON REPRESENTED: Give the full name of the person whom you were appointed to represent.|
|Items 3-6.||DOCKET NUMBERS: Provide the case file or miscellaneous number assigned by the court. Enter the number using the last two digits of the calendar year (YY), the sequential number assigned by the court (NNNNN), and the defendant number (DDD) as shown on the indictment or charging document. Thus, the format of the docket number is YY-NNNNN-DDD. Note: If two or more cases are heard or tried together for the person represented, complete a separate voucher for each case in which representation is provided (i.e., for each docket number listed). Prorate the total time among the cases. On supporting documentation, cross reference all related claims for which costs are prorated.|
|Item 7.||IN CASE/MATTER OF (CASE NAME): In criminal cases, enter U.S. vs. Defendant's Name. If it is a multiple defendant case, give the case cite as provided on the indictment or information (e.g., U. S. vs. Lead Defendant's Name, et al). If the person represented is not a defendant (e.g., material witness), enter the first named defendant in the court's recording of the case. If this is a civil case (e.g., habeas corpus), enter the Name of the Petitioner vs. the Name of the Respondent and include the respondent's title. If other than a civil or criminal case (i.e., miscellaneous matters), enter "In the Matter of" followed by the Name of the Person Represented.|
|Item 8.||PAYMENT CATEGORY: Check the appropriate box that establishes the statutory threshold for representation in this case type. If "Other" payment category is checked, specify the category within the scope of the CJA. See paragraph 2.22 B(2) of the CJA Guidelines.|
|Item 9.||TYPE PERSON REPRESENTED: Check the box that defines the legal status of the person represented.|
|Item 10.||REPRESENTATION TYPE: From the list below, select the code that
describes the type of representation:
CC A defendant charged in a criminal case with an offense(s) that is a felony, misdemeanor, or petty offense under the United States Code, or an assimilated crime under a state code including ancillary matters.
NT A new trial either directed from the court of appeals on remand or as a result of a mistrial
MA Motion attacking a sentence (28 U.S.C. § 2255)
MC Motion to correct or reduce sentence (Fed. R. Crim. P. 35)
HC Habeas corpus, non-capital (28 U.S.C. § 2254)
BP Bail Presentment
WI Material Witness (in custody)
WW Witnesses (Grand Jury, a Court, the Congress, a Federal Agency, etc.)
PR Probation Revocation
PA Parole Revocation
SR Supervised Release Hearing
EW Extraordinary Writs ( Prohibition, Mandamus)
CH Mental Competency Hearings (see Chapter 313 of Title 18 U.S. Code)
PT Pretrial Diversion
EX Extradition Cases (Foreign)
Other (e.g., line ups, consultations, prisoner transfer, etc.)
FOR DEATH PENALTY CASES, USE THE CJA FORM 30 AND APPLICABLE TYPE OF REPRESENTATION CODES
|Item 11.||OFFENSE(S) CHARGED: Cite the U.S. Code, with title and section, or other code citation of the offense or offenses (list up to five) with which the person represented is charged. If other than a federal code is cited, state the statutory maximum period of confinement authorized for the offense. If a civil matter, such as a habeas corpus representation or a motion attacking sentence, cite 28 U.S.C. § 2254 or 28 U.S.C. § 2255, respectively. For direct appeals from a case disposition, cite the major offense (U.S. Code, title and section) for which the defendant was convicted.|
|Items 12/14||ATTORNEY'S NAME AND MAILING ADDRESS and NAME AND MAILING ADDRESS OF LAW FIRM: Complete Item 12 with the legal name and address of the attorney appointed to represent the person whose name is shown in Item 2. If prior to your appointment for representation, you had a pre-existing agreement with a law firm or corporation, including a professional corporation, indicating that CJA earnings belong to the law firm or corporation, rather than to the court-appointed attorney/payee, provide the name and mailing address of that law firm or corporation in Item 14. This information will allow earnings to be reported to the Internal Revenue Service (IRS) on a 1099 Statement as earnings of the law firm or corporation and not as the earnings of the attorney appointed. (Note: Information about a pre-existing agreement, including the Taxpayer Identification Number (TIN) of the law firm or corporation, should be provided to the court staff when the attorney is admitted to the panel or at initial appointment to a case.)|
|Item 13:||COURT ORDER: Check the box that describes the type of counsel appointed. If appointed as a substitute counsel, give the name of the previous counsel and the appointment date. If appointed as a "Standby Counsel," check "Other" and attach a court order establishing this type of appointment in accordance with paragraph 2.17 of the CJA Guidelines. Also check "Other" if counsel is appointed pursuant to 28 U.S.C. § 1875(d)(1) to protect a juror's employment rights, and attach the court order appointing counsel for this purpose. The remaining portion of this item will be completed by the clerk of court or other court-designated person. The presiding judicial officer or clerk of court must sign and date this court order to validate the appointment. If services were provided prior to court appointment, the presiding judicial officer may wish to ratify the previous service by indicating a "nunc pro tunc" date that covers the services prior to appointment. No other court order is necessary. Indicate whether the court orders full or partial repayment of the cost for representation from the person represented at the time of appointment by checking "Yes" or "No."|
|IN-COURT SERVICES: Enter the total number of hours claimed (in hours and tenths of an hour) for each applicable in-court service category. To support the totals entered in each category, attach to the voucher an itemization of services, by date, and indicate the number of hours for each service. Enter the total in-court hours where required on the form, and multiply the total number of in-court hours claimed by the hourly rate in effect for the place of holding court in which the representation is provided or the attorney maintains his or her principal office. If the case is an appeal to the court of appeals, enter the higher of the rates per hour in effect for the place of holding court in which the attorney maintains his or her principal office or the place of holding court out of which the case arose. Enter the total amount claimed in the appropriate box on the form.|
|Item 16.||OUT-OF-COURT SERVICES: Complete according to the instructions
above for in-court time, using the applicable out-of-court hourly rate
NOTE: The "FOR COURT USE ONLY" column will reflect any mathematical or technical adjustments to the claim during the judicial approval process or changes during a required additional review of the chief judge of the court of appeals (or delegate).
|Item 17.||TRAVEL EXPENSES: Travel related expenses that are incidental to the representation (e.g., transportation, lodging, meals, car rental, parking, bridge, road and tunnel tolls, etc.) must be itemized on a separate sheet, indicating dates the expense was incurred. Attach supporting documentation (receipts, canceled checks, etc.) for all travel expenses. Travel expenses by privately owned automobile, motorcycle, or aircraft should be claimed at the rate in effect for federal employees at the time of travel. For overnight travel, reasonable expenses for lodging and meals will be reimbursed on an actual expense basis; per diem is not allowed. Counsel should be guided by prevailing limitations for travel and subsistence expenses of federal employees. The clerk of court can advise you of applicable rates and federal government travel regulations.|
|Item 18.||OTHER EXPENSES: Itemize all reimbursable out-of-pocket expenses
incidental to representation. Provide dates and a brief description of
the expense. Enter the total claimed where required on the form. Submit
supporting documentation (receipts, canceled checks, etc.) for single item
expenses in excess of $50. Reimbursable expenses may include, in some circumstances,
payments to law students or law clerks for legal research and assistance
and the cost of computer assisted legal research (CALR) when conducted
by counsel. See paragraphs 2.31 and 3.15 of the CJA Guidelines for
an explanation. The following are not reimbursable expenses, and should
not be claimed:
1. General office overhead, such as rent, telephone services, and secretarial services.
2. Expenses for items of a personal nature for the client (e.g., clothes, haircuts).
3. The cost of printing briefs. However, the cost of photocopying or similar copying service is reimbursable.
4. Fact witness fees, witness travel costs, and expenses for service of subpoenas. These expenses are not paid out of the CJA appropriation, but instead are paid by the Department of Justice pursuant to Fed. R. Crim. P. 17, and 28 U.S.C. § 1825. Contact the United States Marshal for payment procedures. See paragraph 3.13 of the CJA Guidelines for guidance on payment of witness fees generally.
5. Filing fees. These fees are waived for persons proceeding under the CJA.
6. The cost of allowable investigative, expert, or other services. (See Chapter III of the CJA Guidelines). Such services should be requested using a CJA Form 21.
7. Compensation taxes. Taxes paid on attorney compensation, whether based on income, sales or gross receipts are not reimbursable expenses.
Totals: Enter the Grand Totals where required by adding "in-court" and "out-of-court" totals, "travel" and "other expenses."
|Item 19.||CERTIFICATION OF ATTORNEY/PAYEE FOR PERIOD OF SERVICE: The person appointed by the court must certify dates of service for the representation. Indicate, where required, the date range for the services claimed on the voucher.|
|Item 20.||APPOINTMENT TERMINATION DATE, IF OTHER THAN CASE COMPLETION: If the appointment is discontinued by order of the court (i.e., substitute counsel or reasons other than disposition of the defendant's case, such as fugitive defendant, appointment of federal defender, or retention of counsel by a defendant), give the effective date for termination of appointment.|
|Item 21.||CASE DISPOSITION: Indicate case disposition for the person represented (e.g., dismissed, convicted/final plea guilty, probation revoked, other, etc.). Select a code from the table below.|
|Proceeding||Type of Disposition||Code|
|District Court Criminal and Other Proceedings||Dismissed||1|
|Acquitted by court, or government motion for judgment of acquittal granted||2|
|Acquitted by jury||3|
|Convicted/final plea guilty||4|
|Convicted/final plea nolo||5|
|Not Guilty/insane/court trial||E|
|Not guilty/insane/jury trial||G|
|Other (PTD matters, other reps. Transfers)||X|
|Reversed in Part/Affirmed in Part||RA|
|Affirmed in Part/Reversed in Part||AR|
|Item 22.||CLAIM STATUS: Indicate, by checking the appropriate box, whether the voucher is (1) the final payment for the services, (2) an interim payment, or (3) a supplemental payment (an additional claim submitted after a final payment is made). If an interim payment, indicate the interim payment number. Complete the remaining portion of Item 22, and sign and date the affirmation statement before submitting the claim for court approval.|
|Items 23-28a.||APPROVED FOR PAYMENT: The presiding judicial officer will indicate
the amount approved for payment in each category (Items 23 - 26). These
amounts will reflect any mathematical and technical adjustments to your
claim. The "TOTAL AMOUNT APPROVED/CERTIFIED" for payment
equals the amount approved in the major categories, less any amounts withheld
for an interim payment.
SIGNATURE OF THE PRESIDING JUDICIAL OFFICER: If the total amount approved for payment (both in-court and out-of-court), not including expenses, is less than or equal to the statutory limitation, the claim will be processed for payment. The presiding judicial officer will sign and date the voucher indicating approval of the amount to be paid in Item 27. If compensation exceeds the statutory threshold for the representation, submit a detailed memorandum, supporting and justifying that the representation was provided in a complex or extended case and that the claim for the excess amount is necessary to provide fair compensation. Upon preliminary approval of the claim, the presiding judicial officer will (1) signify approval by circling the word "cert" (for word certified) in Item 27 and (2) forward the voucher to the chief judge of the court of appeals (or delegate) for approval of the excess amount. The JUDGE CODE will be provided by the court staff.
|Item 29-33||APPROVED FOR PAYMENT: For payments in excess of the statutory limitation, the chief judge for the court of appeals (or delegate) will indicate the amount approved for payment in Items 29 - 32. This amount will reflect any adjustments in your claim resulting from additional technical or mathematical review by the chief judge (or delegate). The chief judge of the court of appeals (or delegate) will indicate the TOTAL AMOUNT APPROVED for payment of the claim, less any amounts withheld for an interim payment in Item 33.|
|Item 34.||SIGNATURE OF CHIEF JUDGE, COURT OF APPEALS (OR DELEGATE): Before the claim is paid for the excess amount, the chief judge of the appeals court (or delegate) must sign and date Item 34, approving payment for compensation that exceeds the statutory threshold. If approval is not granted, compensation will be limited to the statutory maximum for the representation and expenses as approved. The JUDGE CODE will be provided by the court staff.|
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