Appointment and Authority to Pay Court Appointed Counsel
Read these instructions carefully before completing the form. Accuracy
and thoroughness will aid in the prompt payment of the claim. If
possible, use a typewriter to complete the form; otherwise, write legibly
with a ball point pen (preferably black or dark blue ink). If the form
is system generated, Items 1 through 12 and 14 will be preprinted on the
form. Attach an itemized statement of the services provided and expenses
incurred. Give the date and the number of hours claimed for each service
provided. Provide dates for and a description of the expenses incurred.
For additional guidance, see the Guidelines for the Administration of
the Criminal Justice Act and Related Statutes (CJA Guidelines), Volume VII, Guide to Judiciary Policies and Procedures, which
is available for reference in the Clerk's office.
Appointed counsel may obtain investigative, expert, and other services
necessary for adequate representation in accordance with the procedures
set forth in subsection(e) of the Criminal Justice Act (CJA), 18 U.S.C.
§3006A. Prior authorization from the presiding judicial officer is
required for all such services where the cost, excluding expenses, will
exceed $300. Failure to obtain prior authorization will result in the disallowance
of any amount claimed for compensation in excess of $300, unless the presiding
judicial officer, in the interest of justice, finds that timely procurement
of necessary services could not await prior authorization. Payment for
these services should be claimed directly by the service provider on a
CJA Form 21, "Authorization and Voucher for Expert and Other Services."
Vouchers shall be submitted no later than 45 days after the final
disposition of the case, unless good cause is shown (Paragraph 2.21A, cja
guidelines). All payments made pursuant to this claim are subject to
post-audit; contemporaneous time and attendance records as well as expense
records must be maintained for three years after approval of the final
voucher (paragraph 2.32, cja guidelines). Any overpayments are subject
to collection, including deduction of amounts due from future vouchers
||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.
||PERSON REPRESENTED: Give the full name of the person whom you
were appointed to represent.
||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.
||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.
||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.
||TYPE PERSON REPRESENTED: Check the box that defines the legal
status of the person represented.
||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
||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
||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.)
||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.
||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).
||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.
||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
2. Expenses for items of a personal nature for the client (e.g., clothes,
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
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."
||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
||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.
||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.
||Type of Disposition
|District Court Criminal and Other Proceedings
|Acquitted by court, or government motion for judgment of acquittal
|Acquitted by jury
|Convicted/final plea guilty
|Convicted/final plea nolo
|Not Guilty/insane/court trial
|Not guilty/insane/jury trial
|Other (PTD matters, other reps. Transfers)
|Reversed in Part/Affirmed in Part
|Affirmed in Part/Reversed in Part
||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.
||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.
||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.
||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.