SUPERIOR COURT – FELONY FORM “A”

INDIGENT DEFENSE APPOINTMENT REPORT

(FILL IN MONTH ABOVE)

CASE # / DEFENDANT NAME
(Last Name, First Name) / DATE APPOINTED / CLASS A, B, C,
“EX” or “PV” / SEX OFFENSE?
Checkif Yes / POINTS
1
0.25, 0.5
or 0 / LIST MOST SERIOUS CHARGE
(New Charges Only, Not PVs)
AND ANY COMMENTS / ADDITIONAL
COMPENSATION
(Administrative Use Only)
Total Points: / Total Additional Compensation:

SUBMIT REPORT TO THE INDIGENT DEFENSE OFFICE BY THE SECOND BUSINESS DAY OF EACH MONTHFOR THE PRECEDING MONTH

CERTIFICATION: By submitting this form, I declare under penalty of perjury that the above appointment report is a true and accurate list of

casesappointed during themonth,pursuant to my 2015/2016 indigent defense contract.

TYPE IN ATTORNEY NAME AND ADDRESS ABOVE

P______C______YTD______

(Revised 1/15)

SUPERIOR COURT – FELONY FORM “B”

INDIGENT DEFENSE DISPOSITION REPORT

(FILL IN MONTH ABOVE)

CASE # / DEFENDANT NAME
(Last Name, First Name) / DATE DISPOSED / CLASS
A, B or C
“EX” or “PV” / DISPOSITION CODE
(See below) / JURY OR BENCH TRIAL?
Trial? Jury or Number
(Check) Bench? of Days / JURY OR BENCH TRIAL
COMPENSATION
(Administrative Use Only)
Total Compensation

DISPOSITION CODES:PG – plead guilty/admit PV; EX – exoneration; DM – dismissed/no PV; WD – withdrawal; DCR – drug court referral;

DIV – diversion; TG – trial guilty; TS – trial split-verdict; TGLI – trial guilty lesser included; TMIS – trial mistrial/hung jury;

TNG – trial not guilty; BW – bench warrant

SUBMIT REPORT TO THE INDIGENT DEFENSE OFFICE BY THE SECOND BUSINESS DAY OF EACH MONTH FOR THE PRECEDING MONTH

CERTIFICATION: By submitting this form, I declare under penalty of perjury that the above disposition report is a true and accurate list of cases disposed during themonth, pursuant to my 2015/2016 indigent defense contract.

TYPE IN ATTORNEY NAME AND ADDRESS ABOVE

(Revised 1/15)

FORM “C”

RCW 10.101.050 MANDATORY NON-CONTRACT CASE MONTHLY OR ANNUALREPORT *

(FILL IN MONTH OR FULL YEAR ABOVE)

TYPE OF
OPEN CASES;
e.g., Family Law / NUMBER OF
OPEN CASES / HOURLY-RATE?
Yes or No / IF HOURLY, LIST TOTAL HOURS ATTORNEY BILLED THIS MONTH OR THIS YEAR / IF NOT HOURLY,
LIST TYPE OF FEE; e.g., Flat Fee or Contingency?

Indigent Defense Contracts or Appointments Outside Clark County

Name of County or City / Contract Term / Case Type(s) / Number of Cases

CERTIFICATION: By submitting this form, I declare under penalty of perjury that the above report is a true and accurate report of non- contract casesand indigent defense cases outside Clark County this month or full year.

TYPE IN ATTORNEY NAME AND ADDRESS ABOVE

* Contractors must report “at least annually”