Michigan > Local County > Macomb > Criminal
Request For Payment Of Court Appointed Attorney Fees (Juvenile) - Michigan
| Request For Payment Of Court Appointed Attorney Fees (Juvenile) Form. This is a Michigan form and can be used in Criminal Macomb Local County . |
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REQUEST FOR PAYMENT OF COURT APPOINTED ATTORNEY FEES (JUVENILE DIVERSION CASES) REQUIRED INFORMATION PLEASE PRINT OR TYPE: Attorney Name Bar No. Tax I.D. No. Street Address Phone Number Fax Number City, State, Zip Macomb County Vendor No. (required) Hearing (Date, Type) On ____________________I was appointed for a ¨ half day ($150) ¨ full day ($300) to: (date of service) 1. Represent: Circuit Court Case Number: 2. Represent: Circuit Court Case Number: 3. Represent: Circuit Court Case Number: 4. Represent: Circuit Court Case Number: 5. Represent: Circuit Court Case Number: In the matter of: In the matter of: In the matter of: In the matter of: In the matter of: I have not received compensation from any source in handling this case. I have no expectation of receiving, nor will I accept, any other compensation. I accept the above requested fees as the full and complete payment for services rendered to date in this case. VERIFICATION UNDER MCR 2.114: I declare that the statements above are true to the best of my information, knowledge, and belief. Signature of Attorney Date FORWARD BILLING TO: OFFICE OF THE JUDICIAL AIDE MACOMB COUNTY COURT BUILDING TH 40 N. MAIN, 5 FLOOR MOUNT CLEMENS, MI 48043 Rev. 2/3/09 Request for Payment of Court Appointed Attorney FeesJuvenile Consent Calendar Hearings American LegalNet, Inc. www.FormsWorkFlow.com
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