Request And Order For Payment Of Court Appointed Counsel (Paternity)

PEOPLE V First Last OAKLAND COUNTY CIRCUIT COURT REQUEST AND ORDER FOR PAYMENT Circuit Court # OF COURT APPOINTED COUNSEL Circuit Judge (PATERNITY) Please print or type Attorney Name Address City, State, Zip Phone Vender ID# Appointment Date PBar no. The above named attorney was appointed to represent the defendant. A complete and accurate record of services rendered appears on the time sheet below DO NOT ALTER TIME SHEET. This matter was disposed by: DATE Dismissal Order of Filiation Other ACTION HOURS TOTAL HOURS I have not received compensation from any source for handling this case. I have no expectation of receiving, nor will I accept any other compensation. Attorney Signature PATERNITY IT IS ORDERED: The above named attorney was appointed to represent this defendant in the above captioned case. (S)he has rendered this service, filed a payment voucher, and shall be paid less any applicable Federal or State Court-ordered and/or statutory lien, levy or garnishment. Dollars from the County Treasury. Please return to: BUSINESS OFFICE OKLAND COUNTY CIRCUIT COURT 1200 N. TELEGRAPH ROAD, DEPT 404 PONTIAC, MI 48341-0404 Questions? Call (248) 452-2078 Fax (248) 975-9877 Additional forms may be obtained from the Court's website: www.oakgov.com OCBD Attorney Voucher Paternity Form (10/10) Circuit Judge American LegalNet, Inc. www.FormsWorkFlow.com