Arbitrator Compensation Voucher And Claim For Expenses Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Arbitrator Compensation Voucher And Claim For Expenses Form. This is a New York form and can be use in District Court Federal.
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Tags: Arbitrator Compensation Voucher And Claim For Expenses, New York Federal, District Court
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF NEW YORK
James M. Hanley Federal Building
P.O. Box 7367, 100 S. Clinton St.
Syracuse, New York 13261-7367
(315) 234-8500
Fax (315) 234-8501
L A W R E N CE K . B A ER M A N
Clerk
J OH N M . D O M U R AD
Chief Deputy
ARBITRATOR COMPENSATION VOUCHER AND CLAIM FOR EXPENSES
(FORWARD TO THE CLERK OF COURT DO NO T E-FILE )
TITLE OF ACTION: _________________________________________________________
CASE NO: ________________________ DATE(S) OF HEARING: __________________
Arbitrators sitting as a panel of three are each compensated at the rate of $100.00 per day of
hearing or portion thereof. Single Arbitrators are compensated at the rate of $250.00 per day of
hearing or portion thereof, in accordance with NYND Local Rule 83.7-4(e).
1) ARBITRATION FEES: $___________ (note rates above) NUMBER OF DAYS__________
2) TRAVEL AND OTHER EXPENSES:
a)
Mileage:
Number of miles __________ @ 44.5 cents per miles = $___________
(Mileage from office to place of hearing and return. Please indicate time of
departure and time of return to office after the hearing):
Time of Departure:________ Time of Return:_________
b)
$_____________ (total me al expense canno t excee d #3 8.00 per d ay)
Meals:
(Attach receipts & indicate breakfast, lunch or dinner)
c)
Lodging: $____________
(Attach receipts - consult with ADR clerk for overnight travel rates.)
d)
Miscellaneous Expenses: $_____________
(Cost of Parking, Tolls, etc. - attach receipts)
Totals (Items 1 and 2a thru d): $________________
Payee ______________________ SSN or Tax ID: ___________________
Address: ____________________________________________________
____________________________________________________
________________________________
Signature of Arbitrator
---------------------------------------------------------------------------------------------------------------------Amount: ________________________
Approved for Payment by:
Date:
____________________
____________________________
Lawrence K. Baerman, Clerk
Date:___________________________
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