Case NumberAttorney/GALIf Capital Offense Case, List Co-Counsel's Name Here:I hereby certify that the following time was expended in representation of the defendant/party represented. ITEMIZED FEE STATEMENTIN-COURTDate of ServiceIn-Court Total Out-of-CourtTotalDailyTotalDate of Service Out-of-CourtTotalDailyTotal IN-COURTIn-Court TotalGrandTotalUse the following categories for Type: (1) Experts (2) Postage/Phone (3) Records/Reports (4) Transcripts (5) Travel (6) Other I hereby certify that the following expenses were incurred: Continue at top of next column.TYPEAMOUNTPAYEETOTALClearly identify each expense and include a receipt for any expense over $1.00. See Section (P)(1)(c) for privileged information.2002 © American LegalNet, Inc.