Fill and Sign the Cja Supervising Attorney Federal Judicial Center Form

TIN: Telephone TO CLAIMANT'S CERTIFICATION FOR PERIOD OF SERVICE CLAIM STATUS Supplemental Payment Interim Payment Number Final PaymentI hereby certify that the above claim is for services rendered and is correct, and that I have not sought or received payment (compensation or anything of value) from any other source for these services. DateSignature of 18. CERTIFICATION OF ATTORNEY I hereby certify that the services were rendered for this case.Signature of APPROVED FOR PAYMENT COURT USE ONLYCJA 31 DEATH PENALTY PROCEEDINGS: EX PARTE REQUEST FOR AUTHORIZATION AND VOUCHER EXPERT AND OTHER SERVICES (Rev. 5/99) 1. CIR./DIST./ DIV. CODE VOUCHER NUMBER 4. DIST. DKT./DEF. NUMBER 3. MAG. DKT./DEF. NUMBER 6. OTHER DKT. NUMBER 5. APPEALS DKT./DEF. NUMBER 8. TYPE PERSON REPRESENTED 7. IN CASE/MATTER OF (Case Name)9. REPRESENTATION TYPE Other Adult DefendantAppellant Dl 28 U.S.C. § 2254 Habeas (Capital) D3 28 U.S.C. § 2255 (Capital)Habeas Petitioner D2 Federal Capital Prosecution Appellee D4 Other (Specify) 10. OFFENSE(S) CHARGED (Cite U S Code, Title & Section) If more than one offense, list (up to five) major offenses charged, according to severity of offense,REQUEST AND AUTHORIZATION FOR EXPERT SERVICES 11.. ATTORNEY'S STATEMENT As the attorney for the person represented, who is named above, I hereby affirm that the services requested are necessary for adequate representation. I hereby request:Authorization to obtain the service. Estimated Compensation and Expenses: $ ORApproval of services already obtained to be paid for by the United States pursuant to the Criminal Justice Act, (See instructions)Date Signature of Pro-Se Panel AttorneyRetained Attorney Legal OrganizationATTORNEY'S NAME (First Name, M.I., Last Name, including any suffix). AND MAILING ADDRESSTelephone Number:12. DESCRIPTION OF AND JUSTIFICATION FOR SERVICES (See Instructions) 13. TYPE OF SERVICE PROVIDER Investigator 01 Other Medical 15Interpreter/Translator 02 16 Voice/Audio AnalystHair/Fiber Expert 03 17 Psychologist04 Psychiatrist Computer (Hardware/ 18Polygraph 05Software/Systems)Documents Examiner 14. COURT ORDER 06 Financial eligibility of the person represented having been established to the Court's 19 Paralegal Services07 satisfaction, the authorization requested in Item 11 is hereby granted. Fingerprint Analyst Legal Analyst/Consultant 2008 Accountant21 Jury ConsultantSignature of Presiding Judicial Officer or By Order of tile Court 22 09 CALR (Westlaw/Lexis, etc.)Mitigation SpecialistDuplication Services Chemist/Toxicologist23 10Date of Order Nunc Pro Tunc Date 11 Ballistics(See Instructions)Other (Specify) Repayment or partial repayment ordered from the person represented for this service at time of authorization. 13 24 Weapons/Firearms/Explosive ExpertNO Pathologist/Medical Examiner YES1415. STAGE OF PROCEEDING Check the box which corresponds to the stage of the proceeding during which the work claimed at Item 16 was performed even if the work is intended to be used in connection with a later stage of the proceeding. CHECK NO MORE THAN ONE BOX. Submit a separate voucher for each stage of the proceeding. HABEAS CORPUSOTHER PROCEEDINGOther Pre-Trial Stay of Execution a.Habeas Petition k.Petition for the l. Appealg.o.e.Trial Petition for the h. b.f.Evidentiary HearingUS Supreme CourtAppeal of Denial of Staym. Writ of Certiorari Dispositive Motions Petition for Writ of certiorari to the U.S. n. SentencingUS Supreme Courtc. AppealSupreme Court Regarding Denial of Stay Writ of Certiorari Other Post TrialCLAIM FOR SERVICES AND EXPENSESFOR COURT USE ONLY SERVICES AND EXPENSES (Attach itemization of services with dates) AMOUNT CLAIMED MATH/TECHNICAL ADJUSTED AMOUNT ADDITIONAL REVIEW a. Compensationb. Travel Expenses (lodging, parking. meals, mileage, etc.) c. Other ExpensesGRAND TOTALS (CLAIMED AND ADJUSTED):17. PAYEE'S NAME (First Name, M.I., Last Name, including any suffix). AND MAILING ADDRESS21 OTHER EXPENSES 19. TOTAL COMPENSATION 22. TOTAL AMOUNT APPROVED/CERTIFIED 20. TRAVEL EXPENSES Either the cost (excluding expense) of these services does not exceed $300, or prior authorization was obtained, OR 23.In the interest of justice the Court finds that timely procurement of these necessary services could not await prior authorization, even though the cost (excluding expenses) exceeds $300.Date Signature of Presiding Judicial OfficerJudge/Mag. Judge Code 27. TOTAL AMOUNT APPROVED 24. TOTAL COMPENSATION26. OTHER EXPENSES 25. TRAVEL EXPENSES 28. FOR REPRESENTATIONS COMMENCED AND APPELLATE PROCEEDINGS IN WHICH AN APPEAL IS PERFECTED ON OR AFTER APRIL 24, 1996, A Total compensation and expense payments approved to date (include amounts withheld for interim payments) for investigative, expert and other services for thisrepresentation is $ B. Payment approved (compensation and expenses) in excess of the statutory threshold for investigative, expert and other services under 21 U.S.C. § 848(q)(10)(B),Date Signature of Chief Judge, Court of Appeals (or Delegate)Judge Code 2. PERSON REPRESENTEDd.i. j. CAPITAL PROSECUTION