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Judicial Hospitalization JH-A1 - Tennessee
| Judicial Hospitalization Form. This is a Tennessee form and can be used in Claim Forms Statewide . |
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FOR M JH -A1 (Rev. 2003) J UDICIAL HOSP ITA LIZA TION ATTORNEY GUARDIAN A D LITEM (Please check one) INSTRUCTIONS: Form JH-A 1 must be submitted in duplicate to the clerk of the court within 90 days of final disposition of case, both copies must be signed by the attorney and the judge. The clerk shall retain one copy and forward the original along with the bill of costs form JH-C1 to the Director of the Administrative Office of the Courts, Nashville, TN 37219. ALL CLAIMS MUST COMPLY WITH THE RULES LISTED ON BACK. STATE OF T ENNESSEE County of Co urt Clerk IN THE MATT ER OF Order entered day of , 20 Docket # SUMMARY OF ACTIVITY TOTALS (A) (B) (C) (D) (From itemized list on back of form) IN-COURT HOURS OUT-OF-COURT HOURS COPIES OR LONG DIST. OTHER (TENTHS) (TENTHS) CALLS ONLY APPROVED @ $50.00 HR. @ $40.00 HR. OUT-OF-POCKET EXPENSE EXPENSE I certify that the foregoing represents an accu rate and Enter FU LL Na m e and C OM PLET E Add ress H ere complete st atement of time and expense i n connection with the above action or procee ding and that these s ervices w ere rendered , Attorney: pursuant to my appointment, in com pliance with Title 33, Chap. 3-8, Mental Health Law, Supr eme C ourt Rules13 and 15. Addres s: Signat ure of Attorney , TN ZIP So cial Se curity No. Phone TO BE COMPL ETE D BY J UDGE AMOUNT 1. Total approved in-court hours at $50.00 p er hour............ ............ ... 2. Total approved out-of court hours at $40.00 p er hour ............ ............ 3. Tota l out-of-pocket expens es (copies or long distance calls only) ............ ............ ... 4. Approved expense s (prior authorization MUST be att ached) ............ ............ ....... TOTAL ATTORNEY /GUARDIA N AD LITEM COSTS AUTHORI ZED I hereby certify that I appointed the above nam ed attorney to represe nt the individual who is the subject of this proceeding, I have found sa id subject to be INDIGEN T as defined by Tenne ss ee Code Annotated 33-1 -101 (14). I further find the time claimed by said attorney as expende d in this cause to be reaso nable and recom m end said attorney be com pens ate d in compliance with Supreme C ourt Rules 13 and 15. This the day of , 20 . Signature of Judge <<<<<<<<<********>>>>>>>>>>>>> 2FO RM JH-A1 (Re v. 2003) JUD ICIAL HOSP ITA LI ZA TION ATTORNEY GUARDIAN A D LITEM (Please ch eck on e) IN THE MATT ER OF Docket # Title 33, Chap. 3-8, Supreme Court Rule 13 (C) (B) COPIES OR ACTIVITY (A) OUT-OF- LONG DIST. IN-COURT COURT CALLS (D) What legal services did you render? Itemize any out-of- HOURS HOURS ONLY OTHER DATE pocket expense. Itemize any other approved expense & (TENTHS) (TENTHS) OUT-OF APPROVED OF attach to the back of this claim a certified copy of the @ $50.00 @ $40.00 POCKET EXPENSE ACTIVITY courts prior approval of such expenses. HR. HR. EXPENSE ATTORNEY TOTALS The following rules govern attorney reimbursement claims in judicial proceedings under Title 33, Chap. 3-8, Mental Health Law, Supreme Court Rules 13 and 15. 1. The maximum hourly rate for attorneys shall not exceed $50.00 per hour for time expended in judicial proceedings, with a total maximum not to exceed $100.00 for each day of in-court proceedings. The maximum hourly rate for attorneys for time reasonably spent in preparing for judicial proceedings shall not exceed $40.00 per hour. 2. The total compensation for any one proceeding shall not exceed $500.00. 3. All claims for compensation shall be specific as to the service performed, the date performed, time in hours and tenths of hours. 4. Out-of-pocket expenses for long distance telephone calls and copying charges incident to the proceeding, shall be reimbursed by listing them on the claim. 5. Other expenses of any nature, including travel, must be approved by the judge of the court having jurisdiction of the proceeding prior to actual incurrence of the expense. Estimates of expense claims for such expected expenses must be specific as to the type of expense incurred, the estimated amount, and the reasons for the expense. Any estimates for travel expenses in excess of 100 miles each way must comply with the state travel regulations and no exceptions will be allowed. No expense requests will be honored for travel of less than 100 miles each way, or 200 miles total. Such expenses will be reimbursed only if they comply with all rules and procedures and are attached to the Attorney Costs Form JH-A1 as a prior authorized order from the judge. 6. No co-counsel or associate attorney will be compensated. 7. If any attorney is substituted for an attorney previously appointed for a party in the same case, the total compensation which may be paid both attorneys shall not exceed the statutory maximum of one proceeding. In such cases, compensation shall not be fixed by the judge until the conclusion of proceeding, so that the judge may make such apportionment between the attorneys as may be just. 8. The form on the front must be completed and submitted to the judge in compliance with instructions listed on front. After the judges authorization has been obtained, attach Form JH-A1 to Form JH-C1 and submit to the director of the Administrative Office of the Courts. 9. This form should be used for attorneys and guardians ad litem appointed in proceedings brought by a superintendent of a state mental health facility pursuant to Title 34, guardianship law. See T.C.A. 33-3-503.
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