GWINNETT COUNTY INDIGENT DEFENSE INVOICE - ATTORNEY CASE NUMBER(S) WARRANT NUMBER(S) THE STATE v. CHARGES: (List the code section and the charge. If you have a document with the charges listed such as the First Appearance Hearing Order, you may attach a copy.) APPOINTMENT DATE: DISPOSITION DATE: JURY TRIAL [ ]Guilty [ ]Not Guilty [ ] DISMISSED [ ] NOLLE PROSEQUI BENCH TRIAL [ ]Guilty [ ] Not Guilty [ ] DEAD DOCKET [ ] OTHER: [ ] PLEA [ ] FAST TRACK PLEA Appointed ON or AFTER January 1, 2010: Capital Felonies: [ ] $65 per hour Appointed PRIOR to January 1, 2010: Capital Felonies: [ ] $75 per hour All Other Cases: [ ] $55 per hour in-court, $45 per hour out-of-court All Other Cases: [ ] $60 per hour in-court; $45 per hour out-of-court Capital Felonies: Murder, Vol. Manslaughter, Rape, Ag. Sodomy, Ag. Assault, Child Molest., Ag. Sex. Battery, Armed Robbery All in-court time must be listed on this invoice. Out-of-court time may be attached on a separate sheet. IN-COURT Bail Hearing Preliminary Arraignment Motions Plea Calendar Call Trial Revocation Sentencing TOTAL $ CLAIMED IN COURT TOTAL HOURS IN COURT TOTAL $ CLAIMED OUT-COURT TOTAL HOURS OUT-COURT TOTAL OTHER EXPENSES Date HRS OUT OF COURT--(LIST) Date HRS Attach an itemization of other expenses. DO NOT PAY EXPERTS, INVESTIGATORS, or DOCTORS. Invoices for these services should be attached to the A.O.C. invoice for experts and investigators along with the order(s) authorizing the service. APPROVAL IN ADVANCE is mandatory. Submit this invoice and a copy of the judge=s order appointing counsel to the Administrative Office of the Courts 75 Langley Drive Lawrenceville, GA 30046 Questions: 770-822-8541 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. ___________________________________________________________________ ATTORNEY SIGNATURE DATE: ATTORNEY NAME AND ADDRESS IN THIS SPACE _________________________________________________________________ NOTARY SIGNATURE & STAMP Do Not Write in This Space for AOC APPROVED: $ APPROVED: $ by AOC by Indigent Defense Governing Committee Initials Initials __________ DATE: DATE: AOC FM [Jan 2010] American LegalNet, Inc. www.FormsWorkFlow.com