IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT DEKALB COUNTY, ILLINOIS IN THE INTEREST OF vs. ____________________________________________, A Minor. ) ) ) ) ) ) ) ) CASE NO.:_________________________________ PAYMENT ORDER FOR THE REIMBURSEMENT FOR A COURT APPOINTED ATTORNEY This cause having come on to be heard on the motion and the Court being fully advised in the subject matter, and having jurisdiction of the subject matter, THE COURT FINDS: 1. The amount stated herein is a reasonable amount to reimburse the County of DeKalb for the cost of a court appointed attorney. 2. The payment ordered herein is based on the present financial circumstances of the defendant. 3. The total amount and the payment(s) may be increased, decreased or suspended upon notice and motion by the court, state’s attorney or defendant as the circumstances require. IT IS HEREBYORDERED that the defendant shall pay the sum of $__________ for reimbursement of the cost of a court appointed attorney as follows: [ ] The total sum of $_______________ on or before ____________________, 20_____. [ ] Installment payments of $_______________ each, beginning on the ____________________, 20_____, and the same amount on the day of each [ ] week [ ] month thereafter until the full amount is paid. BE IT FURTHER ORDERED that any security posted on the defendant’s bond shall be applied as payment under this Order by the Circuit Court Clerk. All payments under this Order shall be made to the DeKalb County Circuit Clerk, DeKalb County Courthouse, 133 West State Street, Sycamore, IL 60178. Failure to make any payment when due or payment by a check which is not paid by the payor’s bank could result in the defendant being found in contempt of court. I have received a copy of this order. Defendant’s Signature Print Name Dated: Address City/State/Zip Judge Telephone No.: (White - Circuit Clerk; Yellow - Public Def.; Pink - DF) H:\FORMS\JU00002JUV Rev.: 5/25/00 American LegalNet, Inc. www.USCourtForms.com