Form 5 Application For Fees And Other Expenses Under The Equal Access To Justice Act {5}

FORM 5 EQUAL ACCESS TO JUSTICE ACT FORM APPLICATION FOR FEES AND OTHER EXPENSES UNDER THE EQUAL ACCESS TO JUSTICE ACT Title 28 U.S.C. §2412(d), Title II of Public Law 96-481, 94 STAT 2325 1. COURT United States Court of Federal Claims 4. NAME OF APPLICANT (One per form ) 2. DATE FILED 3. DOCKET NO. 5. GOVERNMENT AGENCY INVOLVED IN CLAIM (Use agency code on reverse side) 6. NATURE OF APPLICATION A. G Original application under 28 U.S.C. §2412(d)(1)(A) after judgment in civil action against U.S. B. G Appeal of fees and expenses awarded by Lower Court (If Item 6B is checked go to Item 7.) C. G Original application under 28 U.S.C. §2412(d)(3) after review of agency decision. D. G Petition for leave to appeal an administrative agency fee determination under 5 U.S.C. §504(c)(2). 8. ADMINISTRATIVE AGENCY DOCKET NO. 9. DATE 7. APPEAL FROM: G DISTRICT COURT GBANKRUPTCY COURT G OTHER:____________________________________ 7A. DATE FILED IN LOWER COURT 7B. DOCKET NO. FILED IN ADMINISTRATIVE AGENCY 10. SHOWING OF "PREVAILING PARTY" STATUS (28 U.S.C. §2412(d)(1)(B)): Is agency order, court order, or other relevant document attached?G YES G NO 11. SHOWING OF ELIGIBILITY (28 U.S.C. §2412(d)(2)(B)): Is net worth information attached? G YES G NO 12. ENTER ALLEGATION THAT GOVERNMENT POSITION WAS NOT SUBSTANTIALLY JUSTIFIED (28 U.S.C. §2412(d)(1)(B)): 13. FOR EACH AMOUNT CLAIMED, PLEASE ATTACH ITEMIZATION INDICATING SERVICE PROVIDED, DATE, HOURS, AND RATE (28 U.S.C. §2412(d)(2)(A)): AMOUNT CLAIMED A. ATTORNEY FEES.............................................................................................. B. STUDY................................................................................................................ C. ANALYSIS.......................................................................................................... D. ENGINEERING REPORT................................................................................... E. TEST.................................................................................................................. F. PROJECT........................................................................................................... G. EXPERT WITNESS FEES................................................................................. H. OTHER FEES AND EXPENSES - SPECIFY (1)_______________________________________________________ (2)_______________________________________________________ (3)_______________________________________________________ I. TOTAL FEES AND EXPENSES.......................................................................... 14. SIGNATURE 15. DATE $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ $_______________________ NOTE: THIS FORM SHOULD ACCOMPANY YOUR CLAIM WHEN FILED WITH THE CLERK OF COURT American LegalNet, Inc. www.FormsWorkFlow.com EAJA ADMINISTRATIVE AGENCY CODES (Use the following abbreviations for the U.S. Government Agency involved in claim (Item 5)) BENEFITS REVIEW BOARD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (BRB) CIVIL AERONAUTICS BOARD .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (CAB) CIVIL SERVICE COMMISSION (U.S.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (CSC) CONSUMER PRODUCTS SAFETY COMMISSION .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (CPSC) COPYRIGHT ROYALTY TRIBUNAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (CRT) DEPARTMENT OF AGRICULTURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (AGRI) DEPARTMENT OF COMMERCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (COMM) DEPARTMENT OF DEFENSE.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (DOD) DEPARTMENT OF EDUCATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (EDUC) DEPARTMENT OF ENERGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (DOE) DEPARTMENT OF HEALTH, EDUCATION & WELFARE .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (HEW) DEPARTMENT OF HEALTH & HUMAN SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (HHS) DEPARTMENT OF HOMELAND SECURITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (HLS) DEPARTMENT OF HOUSING & URBAN DEVELOPMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (HUD) DEPARTMENT OF INTERIOR .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (DOI) DEPARTMENT OF JUSTICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (DOJ) DEPARTMENT OF LABOR (Except OSHA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (LABR) DEPARTMENT OF TRANSPORTATION SAFETY BOARD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (TRAN) DEPARTMENT OF THE TREASURY (Except IRS).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (TREA) DRUG ENFORCEMENT AGENCY. . . . . . . . . . . . . . . . . . . . . . . . . . .