COURT NON-COURT TIME JUVENILE MATTERS COUNTY . . . . . . . . . .OF SERVICES . . . . . . . . . . MONTHLY .BILL. FOR . . . . . . . . . . RENDERED . . . . . . . . . . . . . . . . . . . . . . : JD-JM-69 Rev. 12-2002 Index No. STATE OF CONNECTICUT SUPERIOR COURT www.jud.state.ct.us INSTRUCTIONS TO ATTORNEY 1. 2. 3. 4. : Calendar No. See detailed instructions on reverse/page 2 of this form, Including court location and client type codes. Use only for billing non-court case preparation for Juvenile Matters cases. Complete one form per case per month, including all services : rendered for that case during that month. Plaintiff(s) Submit one CO-17 at the end of each month, for the total of all non-court time, attaching one JD-JM-69 for each case. Retain copy for your records. -against: ALL INFORMATION MUST BE TYPED OR PRINTED LEGIBLY. JUDICIAL SUBPOENA NAME OF INDIVIDUAL ATTORNEY (First, M.I., Last) JURIS NO. MONTH/YEAR : NAME OF PERSON REPRESENTED (Last, First) CASE NAME : CASE TYPE DOCKET NO. (Including prefix) Defendant(s) : ...................................................... DAY OF MONTH CLIENT CODE COURT CODE HOURS (in 1/10 hour increments) DAILY ACTIVITIES (Include time spent in 1/10 hour increments for each activity. Leave lines blank for days not worked) THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Total non-court hours worked for the above-named case during month: (Multiply total hours of preparation worked by $25.00 per hour to be billed in 1/10 hour increments.) Telephone No.: TOTAL AMOUNT DUE FOR THE ABOVE-NAMED CASE FOR THIS MONTH: Facsimile No.: SIGNED (Attorney) ATTORNEY CERTIFICATION: E-Mail Address: I have worked the hours represented on this document and am due the amount claimed. Mobile Tel. No.: X $ 25.00 DATE SIGNED American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. INSTRUCTIONS FOR SUBMISSION OF BILLS FOR SERVICES RENDERED : 1. Calendar No. In order to receive payment for services rendered out of court after January 1, 1996, attorneys representing clients : in Juvenile Matters cases are required to complete the NON-COURT TIME - JUDICIAL SUBPOENA JUVENILE MATTERS (JD-JM-69) Plaintiff(s) monthly billing form. -against- : Travel time, in the course of case preparation, to court or elsewhere, other than the attorney's office, may be : included. : Court approval in advance shall be required before payment for hours worked in excess of 20 hours is authorized. Approval will be granted in 10-hour increments. Defendant(s) : ...................................................... 2. The definitions of preparation time, allowable expenses and excluded expenses are set forth in the Superior Court Guidelines Concerning Appointment of Attorneys and Guardians Ad Litem for Children and Indigent Parents in Child Protection and Families With Service Needs (FWSN) Cases, in Juvenile Matters incorporated THE PEOPLE Letter of Agreement NEW between by reference in the OF THE STATE OF by andYORK each attorney representing clients in Juvenile Matters cases and the Judicial Branch. 3. Using only one form PER CASE per month, a NON-COURT TIME JUVENILE MATTERS (JD-JM-69) form must be completed for each case in which you rendered services during a given month. All services rendered in one case during one month must be listed on one form. Non-court time rate is $25.00 per hour for preparation of each case, to be billed in 1/1/0 hour increments. GREETINGS: TO 4. At the end of eachCOMMAND attorney must business and excuses being laid aside, you andServicesyou attend before WE month, each YOU, that all submit only one Invoice Voucher for Goods or each of (CO-17) that the Honorable of all non-court services provided on all cases during that month. Documentation of services reflects the total , at the Court provided must be detailed on the NON-COURT TIME JUVENILE MATTERS (JD-JM-69) form for each case in located at County of which you provided services during that month. Each CO-17 must list the appropriate the in room , on the day of , 20 , at o'clock in payee: either the attorneyrecessed noon, and at any withor adjourned date, to testify and give evidence as a witness in this action on the part of the social security number, or the law firm with FEIN. 5. Original completed CO-17 invoices must be submitted to the JUVENILE MATTERS BILLING UNIT no more than 30 days following the end of the month in which services were provided. Failure to submit billing in a timely manner may result in removal fromto comply with this subpoena is properly completed NON-COURT TIME JUVENILE liable to Your failure the panel. CO-17 invoices with punishable as a contempt of court and will make you MATTERS (JD-JM-69) forms attached must be submittedfor a maximumthe following address: damages sustained as a the party on whose behalf this subpoena was issued for payment to penalty of $50 and all result of your failure to comply. JUDICIAL BRANCH/SUPERIOR COURT OPERATIONS DIVISION JUVENILE MATTERS ATTORNEY BILLING UNIT Witness, Honorable , one of the Justices of the 225 SPRING STREET Court in County, day of , 20 WETHERSFIELD, CT 06109 6. CO-17 invoices and NON-COURT TIME JUVENILE MATTERS (JD-JM-69) forms not submitted in accordance with these procedures will be returned for correction. (Attorney must sign above and type name below) CODES COURT LOCATION BP CPS DB HD MT NB NH Bridgeport Middletown Danbury Hartford Middletown New Brittain New Haven NW RV ST TR WB WF WL Norwalk Rockville Stamford Torrington Waterbury Waterford Willimantic CASE TYPE CP FN DL TP Attorney(s) for CLIENT TYPE C Child Child Protection Family With Service Needs P Parent Office andO Other (explain) P.O. Address Delinquency G GAL-Child Termination of B GAL-parent Parental Rights TelephoneV Victim No.: M Mentor Facsimile No.: D A U R L F S Grandparent Aunt Uncle Other relative Legal guardian Foster parent Step parent E-Mail Address: Mobile Tel. No.: JD-JM-69 Rev. 12-2002 (Page 2 of 2) American LegalNet, Inc. www.USCourtForms.com