STATE OF MICHIGAN



STATE OF MICHIGAN

CIRCUIT COURT FOR THE THIRTIETH JUDICIAL CIRCUIT

| | | |

|Name: | |This form cannot be submitted electronically. |

|Firm: | |Complete the form on-line, print a hard copy, |

|Address: | |sign it and present to Ingham County Pretrial Services, |

| | |Attn: Tammy Liston, at 313 W Kalamazoo St Lansing, MI 48933. |

| | |All of this information is required and must be supplied, |

| | |including your original signature. |

|Phone: | | |

| | | |

|Michigan Bar No.: | | |

|Attorney Tax ID #: | |Primary e-mail address: |

| | | |

|Attorney Vendor #: | |Secondary e-mail address: |

| |

By completing and filing this form, attorneys certify that for each electronic mail (e-mail) submitted voucher he/she has been appointed to represent the defendant named in the voucher by an order of the 30th Judicial Circuit. Further, attorneys certify that upon electronic submission of a voucher that he/she has completed the whole of his/her duties under this appointment and is applying for compensation not having received nor expecting to receive any other compensation for services from the defendant or any private person or source and states that the compensation requested is accurate and in accordance with the applicable fee schedule. Further, attorneys acknowledge that vouchers electronically submitted are presumed to be from the assigned attorney if sent from the attorney’s registered email address and the voucher contains that attorney’s personal identifier.

Date:

Attorney’s Signature

Revised: August 11, 2004

-----------------------

E-FILING REGISTRATION FORM

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download