Attorney’s Name Appeal No.______________________ Submit as many copies of the Fees worksheet as needed (Start a new fees worksheet for each hourly rate claimed) Date of Service On or After January 1, 2008 On or After May 20, 2007 Jan. 1, 2006 to May 19, 2007 May 1, 2002 to Dec. 31, 2006 Payment Rate $100 $94 $92 $90 HOURLY COMPENSATION WORKSHEET Enter time spent in hours and tenths of hours. DATE OF SERVICE (A brief description is required) In-court g. Appeals Court a. Interviews & Conferences b. Obtaining & Reviewing Records c. Legal Research & Brief Writing d. Travel Time e. Investigative & Other work Number of hours claimed (This page only) TOTAL In-Court Hours claimed TOTAL Out-of-Court Hours claimed x$ Hourly rate = $ x$ Hourly rate = $ Total Claimed Total Claimed American LegalNet, Inc. www.FormsWorkflow.com Attorney’s Name Appeal No.______________________ Submit as many copies of the Fees worksheet as needed HOURLY COMPENSATION WORKSHEET Enter time spent in hours and tenths of hours. DATE OF SERVICE (A brief description is required) In-court g. Appeals Court a. Interviews & Conferences b. Obtaining & Reviewing Records c. Legal Research & Brief Writing d. Travel Time e. Investigative & Other work Number of hours claimed (This page only) TOTAL In-Court Hours claimed TOTAL Out-of-Court Hours claimed x$ Hourly rate = $ x$ Hourly rate = $ Total Claimed Total Claimed American LegalNet, Inc. www.FormsWorkflow.com Paralegal/Law Student’s Name Appeal No._________________ Submit as many copies of the Fees worksheet as needed LAW STUDENTS/LEGAL ASSISTANTS/PARALEGAL WORKSHEET – Submit on CJA Form 21 Enter time spent in hours and tenths of hours. DATE OF SERVICE (A brief description is required) a. Interviews & Conferences b. Obtaining & Reviewing Records c. Legal Research & Brief Writing d. Travel Time e. Investigative & Other work Number of hours claimed (This page only) TOTAL time claimed x$ Hourly rate = $ Total Expenses Claimed Law Students/legal assistants/paralegals may be reimbursed at the hourly rate. Submit on a CJA Form 21 – indicate the basis for the hourly rate claimed. American LegalNet, Inc. www.FormsWorkflow.com Attorney’s Name Appeal No.______________________ Submit as many copies of the Other Expense worksheet as needed OTHER EXPENSE WORKSHEET - PLEASE ATTACH RECEIPTS DATE OF SERVICE (A brief description is required) In-House copies (Court pays 15¢ per page) Total Dollar Amount Claimed $ Postage Long Distance Outside Copy Services (must provide receipts) (must provide receipts for overnight delivery or courier service) (receipts required for charges in excess of $50) Legal Research (must provide receipts) OTHER $ $ $ $ $ (brief description required) TOTAL Other Expenses Claimed $___________________________ American LegalNet, Inc. www.FormsWorkflow.com Attorney’s Name Appeal No.______________________ Submit as many copies of the Travel Expense worksheet as needed TRAVEL EXPENSE WORKSHEET – PLEASE ATTACH RECEIPTS DATE OF SERVICE (A brief description is required) Total Dollar Amount Claimed Airfare Lodging (provide hotel receipt) Meals Parking Mileage (See instructions for rates) Cab Fare OTHER (brief description required) $ $ $ $ $ $ TOTAL Other Expenses Claimed $___________________________ American LegalNet, Inc. www.FormsWorkflow.com