FORM AF-1 (Rev. 2003) CLAIM FOR ATTORNEY FEES (APPELLATE/TRIAL) INSTRUCTIONS: Type and submit in duplicate to the appropriate clerk of court. Pleas e complete the form in full or it will be returned. Both copies must be signed by the attorney and judge . For trial court claims, the clerk shall retain one copy for the court files and shall forward the original to the Administrative Office of the Courts, Nashville City Center, Suite 600, 5 11 Union Nashville, TN 37219. For appellate claims, the appellate court clerk shall retain one copy for its files and shall forward the o riginal to the appropriate Appellate Court Judge. STATE OF TENNESSEE COUNTY OF: __________________________ Court __________________________ Court of Criminal Appeals Supreme Court (please specify court) Court of Appeals NAME OF CLIENT: _____________________________________________________ Trial Court No.: ___________________________________ Appeal No.: __________________________________________ 1. ____________________________________________ in violation of TCA Section _____________________________ Original Offense 2. Type of case: _____ Felony _____ Misdemeanor _____ Petition for Early Release _____ Juvenile _____ Post Conviction _____ Probation Violation _____ Contempt ____ Other: _____________ _____ First Degree Murder _____ Lead _____ Co -Counsel Did the DA file a notice of intent to seek the death penalty? _____ Yes _____ No If notice was withdrawn give date ______________________________________ 3. Conviction offense___________________________________________ Sentence received_____________________________ 4. Date of disposition_________________________ Date of last activity in relation to the case____________________________ 5. Disposition of case: _____ Plea of guilty _____ Nolle prosequi _____ Trial by jury _____ Trial by judge _____ Other _____ Cert. question SUMMARY OF ACTIVITY TOTALS (A) (B) (C) (From itemized list on back of form) IN-COURT HOURS OUT-OF-COURT HOURS NECESSARY EXPENSES (Tenths) (Tenths) TOTALS Enter FULL Name, Address and Phone Number Here (Please supply full address and phone number.) I certify that the foregoing represents an accurate, complete statement of time and expenses in connection with Attorney: ________________________________________ the above action or proceedings. Address: ________________________________________ ___________________________________________________ _________________________________________________ Signature of Attorney City: __________________ State: _____ Zip ___________ Soc. Sec. No.: _________________________________ Phone: __________________________________________ TO BE COMPLETED BY JUDGE (A) ________ Total Approved In-Court Hours @ $50 Per Hour.............................................. ... (In capital cases, lead counsel @ $100 Per Hour; co-counsel @ $80 Per Hour) (In capital post - conviction cases @ $80 Per Hour) (B) ________ Total Approved Out-of-Court Hours @ $40 Per Hour.......................................... (In capital cases, lead counsel @ $75 Per Hour; co-counsel @ $60 Per Hour) (In capital post - conviction cases @ $60 Per Hour) (C) Total Approved Necessary Expenses ........................................... .......................................... TOTALS.................... Subject to the provisions of T.C.A. 40-14-207, the Court finds this to be reasonable compensation for work done in the above-style case/appeal. This the _____ day of __________________, ______. _______________________________________________________________ Signature of Judge >>>> 2 ACTIVITY (B) (A) OUT-OF Itemize in-court and out-of court hours spent working on this case. IN-COURT COURT (C) Itemize any out-of-pocket expense. DATE Itemize any other approved expenses & attach to this claim a certified HOURS HOURS NECESSARY copy of the court=s prior approval of such expense. (Tenths) (Tenths) EXPENSES TOTALS: