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Civil Case Trial Level Fee Application Order For Payment Judgment Against Parent Or Guardian G-200 - North Carolina
| Civil Case Trial Level Fee Application Order For Payment Judgment Against Parent Or Guardian Form. This is a North Carolina form and can be used in General Statewide . |
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(TYPE OR PRINT IN BLACK INK) STATE OF NORTH Name Of Indigent Client Date Attorney Appointed In The General Court Of Justice District Court Division CAROLINA Superior Court Division Before the Clerk County File No. Additional File Nos. *Complete name, address and SSN of indigent respondent or responsible person(s) on side 2. CIVIL CASE TRIAL LEVEL FEE APPLICATION ORDER FOR PAYMENT JUDGMENT AGAINST PARENT/GUARDIAN G.S. Ch. 7A, Art. 36; G.S. Ch. 7B, Subch. I; G.S. 122C-268(d), -266(d) NOTE: Use this form ONLY for civil cases at the trial level, including child support contempt cases that end in a finding of criminal contempt. DO NOT use this form for criminal cases, juvenile delinquency cases, or appeals. Attorneys should consult IDS Rule 1.9(a)(1) for deadlines on the submission of final fee applications. INSTRUCTIONS: Applicant completes and signs all applicable portions of Section I. If no judgment is entered, trial judge completes and signs Section II only. If judgment is entered, trial judge completes but does not sign Section II, then completes Section III and signs Section IV. Clerk mails private appointed counsel fee applications to: IDS Financial Services Division, Courier Box 56-10-50, Raleigh, NC, OR if courier is not available, mail to P.O. Box 2448, Raleigh, NC 27602. I. APPLICATION I, the undersigned assigned counsel public defender IDS contract counsel guardian ad litem make application for payment and reimbursement of necessary expenses incurred, or for determination of value of services rendered for the indigent. I certify that this information is correct to the best of my knowledge. ORIGINAL PROCEEDING AND DISPOSITION: that describes the most recent disposition. In the applicable section below, check ONE box in each of the two columns. In column 2, check the box A. Appointed Attorneys ONLY (Complete B. below if you are a guardian ad litem.) 1. Original Proceeding Abuse/Neglect/Dependency TPR Competency Civil Commitment Child Support Contempt Other Civil Contempt Other: 2. Disposition (most recent disposition) Adjudicated Abused, Neglected, or Dependent Initial Disposition Entered Review Order Entered Initial Permanency Planning Order Entered Parental Rights Terminated Declared Incompetent Other: Involuntary Commitment Upheld Voluntary Commitment Held in Civil Contempt Held in Criminal Contempt Dismissed Discharged None (Attorney Withdrew) B. Guardians Ad Litem 1. Original Proceeding Abuse/Neglect/Dependency (Respondent GAL) Abuse/Neglect/Dependency (Juvenile GAL, Program Conflict) (Use "Request for Payment of GAL Conflict Attorney Services" form) 2. Disposition (most recent disposition) TPR (Respondent GAL) DSS Initiated TPR (Juvenile GAL, Program Conflict) (Use "Request for Payment of GAL Conflict Attorney Services" form) Private TPR (Juvenile GAL) (charge to AOC) Competency (Respondent GAL) Other: (specify) COMPLETE FOR THIS FEE: (Attach Beginning Date This Fee Requested Time In Court Travel Adjudicated Abused, Neglected, or Dependent Initial Disposition Entered Review Order Entered Initial Permanency Planning Order Entered Parental Rights Terminated Other: Declared Incompetent Dismissed None (Attorney Withdrew) Ending Date This Fee Requested Time In Court Waiting Long Distance Telephone Copying Prior Total Fees And Expenses Allowed By Judge $ detailed time sheets Disposition Date (if final fee) when required by judge. Time must be reported in decimals, Name Of Judge Setting Fee not minutes.) . . Time Out Of Court Other . Total Time Claimed This Fee Total Expenses . $ $ $ $ $ NOTE: In assigned counsel cases, the applicant is always the individual attorney. If payment is to be made to individual applicant, write "same" under payee and give applicant's taxpayer ID No. (Federal Employer ID No. or, if no Federal Employer ID, SSN). If payment is to be made to applicant's firm, give firm name as payee and firm's taxpayer ID No. Name Of Applicant Address Payee (see note) Taxpayer ID No. (see note) Telephone No. Date Signature Of Applicant Email Address II. ORDER TO PAY OR FIX VALUE OF SERVICES Based on the Findings of Fact set out in Section III, the Court ORDERS that the "Total Amount" stated on Line 4 below be: (Assigned Counsel/GAL) paid by the State of North Carolina to the payee named above. (Public Defender/IDS Contractor) fixed as the value of legal services and other expenses of representation rendered by the applicant above. . 1. Hours Approved By The Court 2. Fees Allowed/Value Of Services Rendered (Hours Approved x IDS Rate) = $ 3. Other Necessary Expenses Allowed By The Court $ $ Name Of Judge (Type Or Print) Signature Of Judge 4. TOTAL AMOUNT Date (Over) Note To Judge: You do not need to sign here if you enter judgment and sign Section IV on the reverse. American LegalNet, Inc. www.FormsWorkFlow.com AOC-G-200, Rev. 6/11, © 2011 Administrative Office of the Courts III. FINDINGS OF FACT AND JUDGMENT To enter judgment against the respondent or a responsible person(s) named below, the Court must make one of the following three findings and sign below: 1. This is a juvenile abuse, neglect or dependency proceeding; the applicant is an attorney or guardian ad litem appointed under G.S. 7B-602; and the juvenile has been adjudicated abused, neglected or dependent. 2. This is a proceeding on a motion or petition for termination of parental rights; the applicant is an attorney or guardian ad litem appointed under G.S. 7B-1101.1 or G.S. 7B-1108; and the parental rights of one or both of the juvenile's parents have been terminated. 3. This is a child support contempt proceeding; the applicant is an attorney appointed to represent the respondent in this proceeding; and the respondent has been held in criminal contempt. After due notice to the respondent named below or service of a summons on the responsible person(s) named below, and opportunity to be heard, the Court finds that the indigent client named on the reverse requested and has been provided counsel and other necessary expenses of representation; that the applicant named on the reverse provided services and incurred expenses of which the money value is that stated in Section II on Line 4, plus any interim fees listed in the box in Section I labeled "Prior Total Fees And Expenses Allowed By Judge;" and that the respondent or the responsible parent, guardian or trustee of the juvenile who is named below is financially able to pay the fees and expenses set out on the reverse, and should be held responsible for r
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