Pro Bono Fund Voucher And Request For Reimbursement Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Pro Bono Fund Voucher And Request For Reimbursement Form. This is a New York form and can be use in District Court Federal.
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Tags: Pro Bono Fund Voucher And Request For Reimbursement, New York Federal, District Court
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF NEW YORK
PRO BONO FUND VOUCHER
AND REQUEST FOR REIMBURSEMENT
I,
, duly appointed as counsel pro bono to
represent
in the matter of
v.
Civil Action No.
-CV-
, hereby request reimbursement pursuant to Local Rule 83.3
for expenses incurred in the representation of my pro bono client in the amount of $
.
I certify that the expenses, a detailed copy of which are attached hereto, are reasonable
and necessary. I further understand that absent prior approval of the court, cumulative expenses
in this matter will not exceed $2,000.00.
Dated:
.
Counsel Pro Bono (Signature):
The above application of counsel pro bono is fair and reasonable and payment is
requested from the Northern District of New York’s Pro Bono Fund.
Dated:
.
Presiding Judge (Signature):
IT IS SO ORDERED.
Dated:
.
Chief U.S. District Judge
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