Pro Bono Fund Voucher And Request For Reimbursement (Packet)

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF NEW YORK PRO BONO FUND VOUCHER AND REQUEST FOR REIMBURSEMENT I, , duly appointed as counsel pro bono torepresent in the matter of v. , Civil Action No. -CV- ,hereby request reimbursement pursuant to Local Rule 83.3 for expenses incurred in therepresentation of my pro bono client in the amount of $ . I certify that the expenses, a detailed copy of which are attached hereto, arereasonable and necessary. I further understand that absent prior approval of the court,cumulative expenses in this matter will not exceed $1,200.00.DATED: ________________________________ Counsel Pro Bono The above application of counsel pro bono appointed by the undersigned is fair andreasonable and payment is requested from the Northern District of New Yorks Pro BonoFund. DATED: ________________________________ Appointing JudgeIT IS SO ORDERED. DATED: AT: , New York Chief U.S. District Judge