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Authority To Reimburse Court Appointed Counsel (Civil) Form. This is a Kansas form and can be use in District Court Federal.
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Tags: Authority To Reimburse Court Appointed Counsel (Civil), Kansas Federal, District Court
AUTHORITY TO REIMBURSE COURT APPOINTED COUNSEL (CIVIL)
1. CASE NUMBER
2. IN THE CASE OF
vs.
3. PERSON REPRESENTED (Full Name)
4. NAME OF ATTORNEY
5. ATTORNEY'S ADDRESS (include city, state and zip code)
6. ATTORNEY'S SOCIAL SECURITY NUMBER OR EMPLOYER I.D.
NUMBER
7. DESCRIPTION AND JUSTIFICATION FOR EACH EXPENSE. Use additional sheets if necessary.
8. ATTORNEY'S STATEMENT
9. ESTIMATED AMOUNT
As the attorney for the person represented who is named above,
I hereby affirm that the expenses requested are necessary for
adequate representation pursuant to Local Rule 83.5.3.1. I
hereby request authorization to incur the expense.
$
10. COURT ORDER
Financial eligibility of the person represented having been
established to the court's satisfaction, the authorization
requested in Item 8 is hereby granted not to exceed the
estimated amount.
(Note: As the reimbursement of expenses is
discretionary with the court, prior approval is required.
SELECT ONE:
Initial Request
Supplemental Request
SIGNATURE OF PRESIDING JUDICIAL OFFICER
SIGNATURE OF ATTORNEY
DATE
Estimated expenses over $3,000 approved pursuant to
Local Rule 83.5.3
DATE
TELEPHONE NO.
DATE
SIGNATURE OF CHIEF JUDGE
CLAIM FOR EXPENSES
11. ITEMIZATION OF EXPENSES INCURRED (Include dates and description of expenses and basis
for claim. Attach receipts for expenses incurred. Use additional sheets if necessary.)
A. TOTAL AMOUNT CLAIMED
$
12. PLAINTIFF'S CERTIFICATION
I hereby certify under penalty of perjury that I am without the
financial resources to pay these expenses.
SIGNATURE OF PLAINTIFF
DATE
13. CERTIFICATION OF ATTORNEY I hereby
certify that these expenses were incurred.
ATTORNEY'S SIGNATURE
DATE
APPROVED FOR PAYMENT
14.
SIGNATURE OF PRESIDING JUDICIAL OFFICER
15. TOTAL APPROVED
DATE
JUDGE/MAG. CODE
16. Payment of over $3,000 approved pursuant to Local Rule 83.5.3
SIGNATURE OF CHIEF JUDGE
$
17. ACCOUNTING
CLASSIFICATION
DATE
7/03
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UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF KANSAS
INSTRUCTIONS FOR COUNSEL APPOINTED IN CIVIL CASES
1.
Court appoints an attorney.
2.
Appointed counsel downloads the form AUTHORITY TO REIMBURSE COURT
APPOINTED COUNSEL (CIVIL) and the Procedures of Court Appointed Counsel
In Civil Actions Seeking Special Approval for Reimbursement Pursuant to Local
Rule 83.5.3 from the court’s web site at www.ksd.uscourts.gov.
3.
The attorney completes items 1-9 of the form and submits to the clerk’s office.
4.
The clerk’s office forwards the form to the presiding judge for approval.
5.
The presiding judge signs the form in block 10. If the estimated amount
exceeds $3,000.00, the form will be forwarded to the Chief Judge for
approval.
6.
Upon approval, the courtroom deputy for the presiding judge mails the original
form to the attorney for retention until the termination of the case and forwards a
copy of the form to the Bar Fund Administrator to maintain.
7.
When the case is terminated, counsel seeking reimbursement for expenses will
complete items 11-13 and return the original form to the clerk’s office for final
approval.
8.
Upon receipt of completed form, the clerk’s office will forward it to the
presiding judge for approval.
9.
If the amount approved is over $3000.00, the form will be forwarded to the Chief
Judge for final approval.
10.
The courtroom deputy for the presiding judge forwards the approved form to the
Bar Fund Administrator to process for payment.
11.
The courtroom deputy for the presiding judge also makes a remark on the docket
indicating that the form has been forwarded to the Bar Fund Administrator to
process for payment.
12.
Once payment is disbursed, the Bar Fund Administrator shall notify the
courtroom deputy. The courtroom deputy will then edit the remark on the docket
with a notation regarding the amount disbursed and the date of disbursement.
(11/06)
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United States
District Court
District of Kansas
Office of the Clerk
United States District Court
District of Kansas
Revised March 2005
Procedures of Court Appointed Counsel
In Civil Actions
Seeking Special Approval
for
Reimbursement
Pursuant to Local Rule 83.5.3
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The District of Kansas Local Rule
83.5.3 addresses procedures to be followed
by court-appointed counsel who represent
indigent parties in civil cases. Counsel must
follow these procedures if they wish to seek
reimbursement for out-of-pocket expenditures
which counsel are reasonably compelled to
incur, which the client is not able to pay, and
which are not otherwise recoverable in the
action (including settlement).
As stated in the Rule, “To qualify for
reimbursement, all expenditures must be
approved in advance by the court.” The form
for court appointed counsel and instructions
can be found on the public web site at
www.ksd.uscourts.gov.
When seeking advance approval for
expenses, counsel should complete Items 1
through 9 of the “Authority to Reimburse Court
Appointed Counsel (CIVIL)” form and submit it
to the clerk’s office. The clerk’s office will
forward the form for approval by the presiding
judge and, if the requested amount exceeds
$3,000, by the chief judge as well. Counsel
may expect to be contacted by the presiding
judge and/or the chief judge if further
explanation of the request is necessary. If the
request is approved, counsel will be notified
that they are authorized to incur the expenses.
The original form will be mailed to the attorney
for retention until the termination of the case.
Upon receipt of the completed form, the clerk’s
office will forward the form to the appropriate
judge for approval of payment.
Please remember that if you settle the
case and do not recover your expenses or
reserve the right to seek costs, the judge will
likely deny reimbursement. Since these funds
are being paid from the Court’s Bar
Registration Fund over which the Court has a
responsibility to all members of the Bar that
these funds are properly spent, the Court must
be careful about its stewardship of these funds.
Accordingly, counsel will be required to make
a showing of continuing indigency of the
plaintiff at the time reimbursement is sought.
While the Court appreciates the pro bono
services of counsel, approval and authorization
of expenditures will be limited.
IT IS REQUIRED THAT COUNSEL SEEK
COURT APPROVAL IN ADVANCE OF
INCURRING ANY EXPENSES FOR WHICH
REIMBURSEMENT IS SOUGHT.
Once the case is closed, counsel
seeking reimbursement should complete Items
11 through 13 and return it to the clerk’s office.
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