PROBATE JUDGE FEE DECLARATION - Alabama



PROBATE JUDGE MENTAL COMMITMENT

FEE ITEMIZATION

MENTAL COMMITMENTS

PROBATE COURT __________________ COUNTY CASE # _______________

In the Matter of __________________________________ Date of Petition _____________________

Date of Final Disposition: _________________________ Date Commitment/Recommitment Expires: ____________

Final Disposition: ( ) Dismissed ( ) Committed ( ) Recommitment ( ) Other_________________________

To the State Comptroller:

I have determined that the responsible person(s) is indigent, or that the petitioner is in law enforcement or a public official acting within the line and scope of his/her duties, or that the respondent, petitioner, or both although being possessed of certain limited funds, should not be responsible for the costs incurred in this proceeding, and upon consideration of the information presented to me in this regard, I have therefore ORDERED that the cost allowable under §22-52-14 Code of Alabama, 1975, be paid by the State of Alabama. I hereby make demand on the General Fund of the State of Alabama for the following fees which I have found to be reasonable:

ADVOCATE FOR THE PETITIONER

Attorney Name _________________________ Appointment Date ______________________

(*Attorney fees must be itemized. Attorneys must use Form FRMS-MC1)

Total $_________________

GUARDIAN AD LITEM

Attorney Name _________________________ Appointment Date ______________________

(*Attorney fees must be itemized. Attorneys must use Form FRMS-MC1)

Total $_________________

SPECIAL PROBATE JUDGE (Recommitment) $_________________

MENTAL EVALUATION/EXPERT TESTIMONY $_________________

(Itemized invoice attached for the evaluation or expert witness)

TRANSPORTATION FEES (Itemized invoice attached) $_________________

If other than Sheriff transported respondent attach

explanation

PROBATE COURT COSTS (Itemized invoice attached) $_________________

TOTAL CLAIM $_________________

Respondent covered under: ( ) Medicare ( ) Medicaid ( ) Private Insurance ( ) None

I,_______________________, Judge of Probate of ___________________ County, AL do hereby certify that expenses and fees claimed are true and correct, are reasonable and necessary, and remain unpaid.

Done this the _________ day of _____________, 20___.

____________________________________________

Original Signature of Probate Judge

Revised 02/24/2014

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