STATE OF MICHIGAN JUDICIAL CIRCUIT OAKLAND COUNTY JUVENILE STATEMENT OF SERVICE AND ORDER FOR PAYMENT OF COURT APPOINTED ATTORNEY/GAL CASE NO. In the matter of Attorney N ame Phone # P # Address Vendo r ID City, State, Z ip Appointment Date The above named attorney was appointed to serve as attorney/GAL for . A complete and accurate record of service rendered appears on the time sheet below. Name PROCEEDING PHASE PHASE FEE PER CASE HEARING DATE(S) Preliminary Phase (Preliminary and Initial/Pretrial hearings) I $14 0 Pretrial/ Disposition Phase (one hearing/one day) I - A $175 Plea or Dismissal Phase (multiple hearings/multiple days) II $35 0 Trial or Permanent Wardship (testimony taken) III $525 Each Additional 275 Day of Trial $14 5 per 275 day COURT PROCEEDING TYP E CODE FEE HEARING DATE(S) OR HOUR(S) Neglect Dispositional Review Hearings NDR $1 5 0 per hearing Pre - Termination Permanency Planning Hearings PPH $165 per hearing Delinquent Dispositional Review Hearings DDR $90 per hearing Permanent Custody Review Hearings (inc . Post - Term . Perm. Plan .) PCR $90 per hearing Motion (hearing time only) MIS $7 0 per hour Adoption Hearings ADO $14 5 per 275 day Parental Waiver/Bypass (attach signed order appointing) PAR $14 5 per case Saturday Preliminary Hearings SAT $14 5 per 275 day Sta ndby Attorney ( paid if no cases are assigned) MIS $14 5 per 275 day Appeals (attach itemized statement ) max $1000 per case APP $60 per hour Family Team Meetings (GALs and Attorneys paid) MIS $ 70 per meeting Misc/Other/Mileage MIS Extraordinary Fees PLEASE PROVIDE AN ITEMIZED EXP L ANATION. Rate is $60 per hour. d cas eworkers. In addition, I have met with and observed the child before every proceeding or hearing and/or reviewed the agency case file. I declare that the above statements are true to the best of my information, knowledge, and belief. Date Attorney Signature ORDER IT IS ORDERED: The above named attorney rendered this service, filed a payment voucher, and shall be paid (less any applicable Federal or State court ordered and/or statutory lien, levy or garnishment) dollars from the County Treasurer. Date Circuit/Probate Judge Please Return to: OFFICE OF THE COURT ADMINISTRATOR OAKLAND COUNTY CIRCUIT COURT 1200 N. TELEGRAPH ROAD, DEPT 404 PONTIAC, MI 48341 - 0404 Questions? Call ( 248) 858 - 1803 Fax: (248) 975 - 9877 ORI MI - 630013J CCFJ 1000 (4/2/18) STATEMENT OF SERVICE AND ORDER FOR PAYMENT OF COURT APPOINTED ATTORNEY/GAL American LegalNet, Inc. www.FormsWorkFlow.com