GWINNETT COUNTY INDIGENT DEFENSE INVOICE - INVESTIGATOR CASE NUMBER(S) WARRANT NUMBER(S) THE STATE v. CHARGES: APPOINTMENT DATE: DISPOSITION DATE: JURY TRIAL [ ] Guilty [ ] DISMISSED [ ] Not Guilty [ ]NOLLE PROSEQUI BENCH TRIAL [ ] Guilty [ ] DEAD DOCKET [ ] Not Guilty [ ] PLEA [ ] OTHER__________________________________________________ Check one “ Death Penalty--$45.00 per hour “ Non-death Penalty --$35.00 per hour HRS Prior approval is required for travel time, food and lodging; photocopying; and the use of more than one investigator on a case. Travel time is paid at the rate of 48.5 cents per mile and photocopying at the rate of 104 per copy with prior approval. Witness Interview Research Serve Documents Meet with Attorney Attach itemizations of any additional expenses and order(s) authorizing expense. APPROVAL IN ADVANCE is mandatory. Meet with Client Review Police Records Submit this invoice and a copy of the judge=s order authorizing the service to the Administrative Office of the Courts 75 Langley Drive Lawrenceville, GA 30045. Questions: 770-822-8541. Preparation for Trial Attend Court Other TOTAL $ CLAIMED IN COURT TOTAL $ CLAIMED OUT-COURT TOTAL OTHER EXPENSES DATE INVOICE SUBMITTED INVOICE TOTAL I swear the above claim is true and correct. I further swear that if I appeared in court on the same day on multiple indigent cases, I have prorated the cost of my services. I understand that this invoice is subject to a full audit by the Gwinnett County Indigent Defense Governing Committee. INVESTIGATOR SIGNATURE NOTARY SIGNATURE & STAMP DATE: SSN or FEIN NUMBER: YOUR NAME & ADDRESS IN THIS SPACE Do Not Write in This Space for AOC APPROVED: $ by Court Administration Initials DATE: APPROVED: $ by Indigent Defense Governing Committee Initials DATE: AOC FM 6B [Jan 07] American LegalNet, Inc. www.FormsWorkflow.com AOC FM 6B [Jan 07] American LegalNet, Inc. www.FormsWorkflow.com