Change of Venue – Expense Certification TRANSFER TO: District Court, _______________________ County TRANSFER FROM: District Court, _______________________ County Case Style: _____________________________________________ Case Number: _____________________________________________ Date of Trial: _____________________________________________ Pursuant to 22 O.S. §562, the court fund of the county from which an action is removed shall be liable for all the expenses as may be lawfully incurred incident to the trial, except as otherwise provided. Said expenses shall be approved by the Administrative Director of the Supreme Court and certified by the clerk of the court to which the action was transferred, to the court clerk of the county from which the cause was removed and shall itemize the names and amounts incurred by each person. During the trial of the above-styled matter, the court fund of ______________________ County incurred the following costs: Juror Fees and Mileage (as reflected on Attachment A) $______________________ Witness Fees and Mileage (as reflected on Attachment B) $______________________ Court Reporter’s Fees (as reflected on Attachment C) $______________________ Sheriff’s Fees and Mileage (as reflected on Attachment D) $______________________ Bailiff’s Per Diem (as reflected on Attachment E) $______________________ Other Trial Expenses (as listed and described on Attachment F) $______________________ Total Expenses $______________________ I hereby certify that the above-listed charges are true and correct and were incurred in the trial of the above-styled case on a Change of Venue to ____________________ County. I hereby request that the sum of $__________________ be paid from the court fund of the _______________________ County District Court directly to the court fund of _________________ American LegalNet, Inc. www.USCourtForms.com County District Court for reimbursement of costs incurred in the trial of the above-styled case due to a change of venue. _____________________________ Date ___________________________________ Court Clerk of _________________ County (County transferred to) …………………………………………………………………………………………………………………………. The costs and expenses in the sum of $_________________ for the trial of the above-styled case as detailed by the attached exhibits are hereby approved. _____________________________ ___________________________________ Date Administrative Director, Supreme Court Note: If the court fund of the county from which the action was removed does not contain sufficient revenue to make payment to the court where the action was transferred, the court clerk of the payor county shall notify the Administrative Director of the Courts who shall make payment of any deficiency in the amount due and owing to the payee county from the Supreme Court Revolving Fund (22 O.S. §562E) This form must also be submitted to the Administrative Office of the Courts with your quarterly financial report for the period the case was concluded. Your quarterly financial report should not reflect the receipt of these monies from the payor county, nor should it reflect the payment of expenses incurred in the Change of Venue. AOC Form 14 Revised 8/05 American LegalNet, Inc. www.USCourtForms.com