Form Instructions
Read these instructions carefully before completing the form. Accuracy and thoroughness will aid in the prompt payment of the claim. Please type or print clearly in blue or black ink. If the form is system-generated, Items 1 through 12 and 14 will be preprinted on the form. Attach an itemized statement specifying the date and a description of the services provided and expenses incurred. For additional guidance, see the Guidelines for Administering the CJA and Related Statutes (CJA Guidelines), Volume 7A, Guide to Judiciary Policy.
Appointed counsel may obtain investigative, expert, and other services necessary for adequate representation in accordance with the procedures set forth in subsection (e) of the Criminal Justice Act (CJA), 18 U.S.C. § 3006A . Prior authorization from the presiding judicial officer is required for all such services where the cost, excluding expenses, will exceed the limitations listed in CJA Guidelines § 310.20.30(a). Failure to obtain prior authorization will result in the disallowance of any amount claimed for compensation in excess of those limits, unless the presiding judicial officer, in the interest of justice, finds that timely procurement of necessary services could not await prior authorization. See 18 U.S.C. § 3006A(e)(2) and CJA Guidelines § 310.20.30(b). Payment for these services should be claimed directly by the service provider on a CJA Form 21, "Authorization and Voucher for Expert and Other Services."
Vouchers should be submitted no later than 45 days after the final disposition of the case, unless good cause is shown (CJA Guidelines § 230.13(a)). All payments made pursuant to this claim are subject to post-audit; contemporaneous time and attendance records as well as expense records must be maintained for three years after approval of the final voucher (CJA Guidelines § 230.76). Any overpayments are subject to collection, including deduction of amounts due from future vouchers.
Appointed counsel should review their vouchers to ensure that they do not contain errors, duplicate payment claims, or other improper charges. Appointed counsel should also review their billing practices to ensure that claims are appropriate.
Item 1. CIR./DIST./DIV. CODE:
This four-character location code is the circuit or district and divisional office code of the court where the proceedings for the person represented are held. These codes are entered automatically by the payment system or manually by court staff.
Item 2. PERSON REPRESENTED:
Give the full name of the person represented.
Items 3-6. DOCKET NUMBERS:
Provide the case number assigned by the court. Enter the number using the last two digits of the calendar year (YY), the sequential number assigned by the court (NNNNNN), and the defendant number (DDD) as shown on the indictment or charging document. The format of the docket number is YY-NNNNNN-DDD. Note: If two or more cases are heard or tried together for the person represented, complete a separate voucher for each case in which representation is provided (i.e., for each docket number listed). Prorate the total time among the cases. On supporting documentation, cross reference all related claims for which costs are prorated.
Item 7. IN CASE/MATTER OF (CASE NAME):
In criminal cases, enter U.S. v. Defendant's Name. If it is a multiple defendant case, give the case caption as provided on the indictment or information (e.g., U.S. v. Lead Defendant's Names, et al). If the person represented is not a defendant (e.g., material witness), enter the first-named defendant in the court's recording of the case. If this is a civil case (e.g., habeas corpus), enter the Name of the Petitioner v. Name of the Respondent and include the respondent's title. If other than a civil or criminal case (i.e., miscellaneous matters), enter "In the Matter of" followed by the Name of the Person Represented.
Item 8. PAYMENT CATEGORY:
Check the appropriate box that establishes the statutory maximum for representation in this case type. If "Other" payment category is checked, specify the category within the scope of the CJA. See 18 U.S.C. § 3006A(a) and CJA Guidelines § 230.23.20.
Item 9. TYPE PERSON REPRESENTED:
Check the box that defines the legal status of the person represented.
Item 10. REPRESENTATION TYPE:
From the list below, select the code that describes the type of representation:
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CC A defendant charged in a criminal case with an offense(s) that is a felony, misdemeanor, or petty offense under the United States Code, or an assimilated crime under a state code including ancillary matters. |
FOR DEATH PENALTY CASES, USE THE CJA FORM 30 AND APPLICABLE TYPE OF REPRESENTATION CODES
Item 11. OFFENSE(S) CHARGED:
Cite the U.S. Code, with title and section, or other code citation of the offense or offenses (list up to five) with which the person represented is charged. If a statute outside of the federal code is cited, state the statutory maximum period of confinement authorized for the offense. For a civil matter, such as a habeas corpus representation or a motion attacking a sentence, cite 28 U.S.C. § 2254 or 28 U.S.C. § 2255, respectively. For direct appeals, cite the major offense (U.S. Code, title and section) for which the defendant was convicted.
Items 12/14. NAME AND MAILING ADDRESS OF ATTORNEY LAW FIRM:
Please list the appointed attorney's legal name and address in Item 12. If prior to appointment, the attorney had a pre-existing agreement with a law firm or corporation, including a professional corporation, indicating that CJA earnings belong to the law firm or corporation, rather than to the court-appointed attorney/payee, provide the name and mailing address of that law firm or corporation in Item 14. This information will allow earnings to be reported to the Internal Revenue Service (IRS) on a 1099 Statement as earnings of the law firm or corporation and not as the earnings of the attorney appointed. (Note: Information about a pre-existing agreement, including the Employee Identification Number (EIN) of the law firm or Corporation, should be provided to the court staff when the attorney is admitted to the panel or at initial appointment to a case).
Item 13. COURT ORDER:
Check the box that describes the type of counsel appointed. If appointed as substitute counsel, give the name of the previous counsel and the appointment date. See § 220.55 of the CJA Guidelines. Check "Other" if counsel is appointed pursuant to 28 U.S.C. § 1875(d)(1) to protect a juror's employment rights and attach the court order appointing counsel for this purpose. See CJA Guidelines §§ 210.20.60, 210.20.30(c)(5), and 230.23.20. The remaining portion of this item will be completed by the clerk of court or other court-designated person. The presiding judicial officer or clerk of court must sign and date this court order to validate the appointment. If services were provided prior to court appointment, the presiding judicial officer may wish to ratify the previous service by indicating a "nunc pro tunc" date that covers the services prior to appointment. No other court order is necessary. Indicate whether repayment of the cost of representation (either full or partial) is ordered by the court from the person represented by checking "Yes" or "No."
Item 15. IN-COURT SERVICES:
Enter the total number of hours claimed (in hours and tenths of an hour) for each applicable, in-court service category. To support the totals entered, attach an itemization of services, by date, and indicate the number of hours claimed for each service. Enter the total in-court hours where required on the form, and multiply the total number of in-court hours claimed by the hourly rate in effect at the time of service. Enter the total dollar amount claimed in the appropriate box on the form.
Item 16. OUT-OF-COURT SERVICES:
Complete this section referring to the instructions above for in-court time.
NOTE: The "FOR COURT USE ONLY" column will reflect any mathematical or technical adjustments to the claim during the judicial approval process or changes made during a required additional review by the chief judge of the court of appeals (or delegate).
CJA Guidelines §230.50 provides information with respect to the proration of claims.
Time spent in common, either in or out of court, on more than one CJA representation must be prorated appropriately among the representations. (Travel and other expenses incurred in common on more than one CJA representation must be billed to one of the representations. See Items 17 and 18.) Time spent in common includes work performed simultaneously or within the same unit of time for more than one representation. For example, an appointed attorney who travels on behalf of more than one CJA representation must prorate the travel time and may not bill the entire time on one voucher. Double billing of time (or expenses) is prohibited (e.g., billing the same travel time or expenses to more than one representation). The supporting materials to the vouchers must explain the method of billing and cross-reference the cases.
Proration of time among representations must not result in an attorney billing more time than would otherwise have been billed had the attorney assigned all of the time to one voucher. For example, an attorney who spends a tenth of an hour (currently the lowest unit of time that may be claimed) in common with more than one CJA representation should assign the one-tenth hour to one of the vouchers. Thus, proration could result in time not being billed for each representation for which time was spent in common.
If an attorney is submitting a claim under the CJA for time (or expenses), including travel, that was spent in common for CJA and non-CJA purposes, the attorney must report such information to the court and explain the rationale for invoicing all or part of the time (or expenses) under the CJA as provided by CJA Guidelines §230.50(g) so that the court can determine whether, in fairness to counsel, the time (or expenses) should be apportioned and the attorney compensated for the time (or expenses) reasonably attributed to the CJA.
Item 17. TRAVEL EXPENSES:
Travel-related expenses that are incidental to the representation (e.g., transportation, lodging, meals, car rental, parking, bridge, road and tunnel tolls) must be itemized on a separate sheet, indicating the date the expense was incurred. Attach supporting documentation (e.g., receipts, canceled checks) for all travel expenses. Travel expenses by privately-owned automobile, motorcycle, or aircraft should be claimed at the rate in effect for federal employees at the time of travel. Claims for mileage reimbursement must include the starting location, the destination, and the number of miles traveled. For overnight travel, reasonable expenses for lodging and meals will be reimbursed on an actual expense basis; per diem is not allowed. Counsel should be guided by prevailing limitations for travel and subsistence expenses of federal employees. The clerk of court can provide advice about applicable rates and federal government travel regulations. See CJA Guidelines §§ 230.46, 230.60, 230.63.40.
When an appointed attorney travels in connection with more than one CJA representation, the travel expenses must be billed to one representation. The supporting materials to the voucher on which the expenses are billed must cross-reference the other CJA representations. See CJA Guidelines §230.50(f).
See Item 16 regarding the billing of travel expenses incurred in common for a purpose other than a CJA representation.
Item 18. OTHER EXPENSES:
Itemize all reimbursable out-of-pocket expenses incidental to representation. Provide dates and a brief description of the expense. Enter the total dollar amount claimed where required on the form. Submit supporting documentation (e.g., receipts and/or canceled checks) for single item expenses in excess of $50.
When an appointed attorney incurs expenses in connection with more than one CJA representation, the expenses must be billed to one representation. The supporting materials to the voucher on which the expenses are billed must cross-reference the other CJA representations. See CJA Guidelines §230.50(f).
See Item 16 regarding the billing of expenses incurred in common for a purpose other than a CJA representation.
The following are not reimbursable expenses and should not be claimed (see Guidelines § 230.66)
Note: The cost of allowable investigative, expert, or other services. (See Chapter 3, CJA Guidelines). Such services should be requested using a CJA Form 21. |
Totals. Enter the Grand Totals where required by adding "in-court" and "out-of-court" totals, "travel" and "other expenses."
Item 19. CERTIFICATION OF ATTORNEY/PAYEE FOR PERIOD OF SERVICE:
The person appointed by the court must certify dates of service for the representation. Indicate, where required, the date range for the services claimed on the voucher.
Item 20. APPOINTMENT TERMINATION DATE, IF OTHER THAN CASE COMPLETION:
If the appointment is discontinued by order of the court (i.e., substitute counsel or reasons other than disposition of the defendant's case, such as fugitive defendant, appointment of federal defender, or retention of counsel by a defendant), give the effective date for termination of appointment.
Item 21. CASE DISPOSITION:
Indicate case disposition for the person represented (e.g., dismissed, convicted/final plea guilty, probation revoked, other, etc.). Select a code from the table below.
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Type of Disposition |
Code | |
| District Court Criminal and Other Proceedings | ||
|
|
Dismissed | 1 |
| Acquitted by court, or government motion for judgment of acquittal granted | 2 | |
| Acquitted by jury | 3 | |
| Convicted/final plea guilty | 4 | |
| Convicted/final plea nolo | 5 | |
| Convicted/court trial | 8 | |
| Convicted/jury trial | 9 | |
| Mistrial | C | |
| Not Guilty/insane/court trial | E | |
| Guilty/insane/court trial | F | |
| Not guilty/insane/jury trial | G | |
| Guilty/insane/jury trial | H | |
| Other (PTD matters, other reps. Transfers) | X | |
| Appeals | ||
| Affirmed | A | |
| Reversed | R | |
| Remanded | 0 | |
| Reversed in Part/Affirmed in Part | RA | |
| Affirmed in Part/Reversed in Part | AR | |
| Dismissed | 1 | |
|
Probation/Parole/ Supervised Release |
||
| Revoked | RV | |
| Restored | RS | |
| Habeas/Petitions/Writs | ||
| Granted | GR | |
| Denied | DE |
Item 22. CLAIM STATUS:
Indicate, by checking the appropriate box, whether the voucher is (1); the final payment for the services, (2); an interim payment, or (3) a supplemental payment (an additional claim submitted after a final payment is made). If an interim payment, indicate the interim payment number. Complete the remaining portion of Item 22, and sign and date the affirmation statement before submitting the claim for court approval.
Items 23-28a. APPROVED FOR PAYMENT:
The presiding judicial officer will indicate the amount approved for payment in each category (Items 23 - 26). These amounts will reflect any mathematical and technical adjustments to your claim. The "TOTAL AMOUNT APPROVED/CERTIFIED" for payment equals the amount approved in the major categories, less any amounts withheld for an interim payment.
SIGNATURE OF THE PRESIDING JUDICIAL OFFICER: If the total amount approved for payment (both in-court and out-of-court), not including expenses, is less than or equal to the statutory limitation, the claim will be processed for payment. The presiding judicial officer will sign and date the voucher indicating approval of the amount to be paid in Item 27. If compensation exceeds the statutory threshold for the representation, submit a detailed memorandum, supporting and justifying that the representation was provided in a complex or extended case and that the claim for the excess amount is necessary to provide fair compensation. Upon preliminary approval of the claim, the presiding judicial officer will (1) signify approval by circling the word "cert" (for word certified) in Item 27 and (2) forward the voucher to the chief judge of the court of appeals (or delegate) for approval of the excess amount. The JUDGE CODE will be provided by the court staff.
Item 29-33. APPROVED FOR PAYMENT:
For payments in excess of the statutory limitation, the chief judge for the court of appeals (or delegate) will indicate the amount approved for payment in Items 29 - 32. This amount will reflect any adjustments in your claim resulting from additional technical or mathematical review by the chief judge (or delegate). The chief judge of the court of appeals (or delegate) will indicate the TOTAL AMOUNT APPROVED for payment of the claim, less any amounts withheld for an interim payment in Item 33.
Item 34. SIGNATURE OF CHIEF JUDGE, COURT OF APPEALS (OR DELEGATE):
Before the claim is paid for the excess amount, the chief judge of the appeals court (or delegate) must sign and date Item 34, approving payment for compensation that exceeds the statutory threshold. If approval is not granted, compensation will be limited to the statutory maximum for the representation and expenses as approved. The JUDGE CODE will be provided by the court staff.