NOTE: DECLARATION REGARDING ATTORNEYS’ FEES AND COSTS (FORM # DC02) IS NOT REQUIRED FOR FEES OF $500 OR LESS or FOR COSTS OF FILING FEES, SERVICE FEES AND MILEAGE UNLESS OTHERWISE ORDERED BY THE COURT CommonLook® 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com DECLARATION REGARDING ATTORNEYS’ FEES AND COSTS; EXHIBITS IN THE DISTRICT COURT OF THE SECOND CIRCUIT _________________________________ DIVISION STATE OF HAWAI‘I Plaintiff(s) Reserved for Court Use Civil No. Filing Party/Attorney Name, Attorney Number (if applicable), Address, Telephone and Fax Numbers Defendant(s) DECLARATION REGARDING ATTORNEYS’ FEES AND COSTS I declare that I am the attorney for the prevailing party, and I request an award of attorneys’ fees pursuant to Hawai‘i Revised Statutes [check all that apply]: G § 607-14 (assumpsit); G § 666-14 (summary possession); G Other [specify statute] § G § 514A-94 (condominium association); . The amount of the judgment (principal and interest) is anticipated to be $__________________. I. ATTORNEY’S FEES (Select A or B)* *PLEASE NOTE: In addition to completing section A or B below, you must attach as Exhibit 1 an itemized report of the time spent on the action and to be spent to obtain a final written judgment, the hourly rates, a brief description of the work performed, and the total fees requested G A. Fee Based on an Hourly Rate. I have expended and am likely to expend to obtain a final written judgment the following hours at the rate specified below. Hours: ___________________ x Hourly Rate: $ ________________ Total Fees = $ ______________________. G B. Fee Based on an Agreed-Upon Fee (Explain the fee agreement below). The attorney’s fee incurred in this action is not based on an hourly rate. The agreed-upon fee is $______________________. TOTAL FEES REQUESTED: $_____________________________ (Rev. 1 December 2006) Reprographics (07/10) CommonLook® 508 Certified Page 1 of 2 CONTINUED TO PAGE 2 Form#2DC02 2D-P-215 American LegalNet, Inc. www.FormsWorkFlow.com DECLARATION REGARDING ATTORNEYS’ FEES AND COSTS (continued) II. OTHER COSTS I request an award of costs for actual disbursements itemized below pursuant to Hawai‘i Revised Statutes [check all that apply]: G Other [specify statute]: § ____________________, G § 607-9; I have attached as Exhibit 2 true copies of invoices and/or receipts for the requested costs. *PLEASE NOTE: Do not include filing fees, service costs or mileage in your request for other costs. Such costs should be reflected on the Judgment form but do not require additional court approval. Item Amount Requested TOTAL OTHER COSTS REQUESTED: $ _____________________________ I DECLARE UNDER PENALTY OF LAW THAT THE FOREGOING IS TRUE AND CORRECT. Signature of Declarant: Date: Print/Type Name: ORDER Approved and so Ordered: Attorney’s Fees: $ ________________ Other Costs: $_________________ Judge In accordance with State and Federal disability laws, if you require an accommodation for a disability when working with a court program, service, or activity, please contact the District Court Administration Office at PHONE NO. 244-2800, FAX 244-2849, or TTY 244-2889 at least ten (10) working days before your proceeding, hearing, or appointment date. For Civil-related matters, please call 244-2706 or visit the Service Center at 2145 Main Street, Rm. 141A, Wailuku, HI 96793 (Rev. 1 December 2006) Reprographics (07/10) CommonLook® 508 Certified Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Form#2DC02 2D-P-215