United States Court of Appeals for the Fourth Circuit SAMPLE Page Case Number 1 of 2 04-6000 Court-Assigned Counsel Worksheet - Services Brief Description of Services1 Date Time Spent in Hours and Tenths of Hours 02/15/05 Review transcripts 2.50 02/25/05 T/C w/4CCA re extension of time 02/26/05 Revise brief 1.50 08/22/05 Travel to and from Richmond for oral argument 6.00 .20 PAGE TOTAL 10.20 United States Court of Appeals for the Fourth Circuit Page Case Number 2 of 2 04-6000 Court-Assigned Counsel Worksheet - Expenses2 Date Brief Explanation of Expenses 02/25/05 Meals 705 copies of brief & joint appendix @ $.15 03/17/05 Lodging Other Travel Expenses Copying4 Postage T/C w/4CCA re extension of time 03/17/05 Travel3 Toll Calls Other Misc. Expenses 1.82 UPS to opposing counsel 105.75 12.00 08/22/05 08/22/05 350 miles @ 40.5 cents/mile for oral argument 141.75 Dinner 9.75 PAGE TOTAL 105.75 141.75 1 9.75 1.82 12.00 Expended time must show nature of work performed, dates executed, and time must be listed in hours and tenths of an hour. 2 All travel expenses and miscellaneous expenses over $50.00 must be supported with detailed receipts. Credit card receipts are not considered acceptable documentation. Telephone toll calls must be itemized. 3 Mileage for counsel is limited to 36 cents per mile for travel on or after 1/1/03, 37.5 cents per mile for travel on or after 1/1/04, 40.5 cents per mile for travel on or after 2/4/05, 48.5 cents per mile for travel on or after 9/1/05, 44.5 cents per mile for travel on or after 1/1/06, and 48.5 cents per mile for travel on or after 2/1/07. Airfare is limited to the cost of "coach class". 4 If photocopies are made in counsel's office, the date, number of copies, and the cost per copy must be recorded. If copies are procured out of the office, a detailed receipt for those copies needs to be attached to the voucher. Reimbursement shall not exceed 35 cents per copy for photocopying and other services in preparation of briefs and appendices by commercial printers. American LegalNet, Inc. www.FormsWorkflow.com United States Court of Appeals for the Fourth Circuit Page of Case Number Court-Assigned Counsel Worksheet- Services Date Brief Description of Services Hours and Tenths of Hours PAGE TOTAL American LegalNet, Inc. www.FormsWorkflow.com United States Court of Appeals for the Fourth Circuit Page of Case Number Court-Assigned Counsel Worksheet - Expenses Date Brief Explanation of Expenses Travel Lodging Meals Other Travel Expenses Copying Postage Toll Calls Other Misc. Expenses PAGE TOTAL American LegalNet, Inc. www.FormsWorkflow.com