Case Number 

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Jurisdiction     Year     Case#          Suffix  

   

 

County 
Code 
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ATTORNEY’S FEE DECLARATION
(Adult) 
[For Appointments made prior to 6/14/2011] 

Unified Judicial System 
orm AFD-1      Rev.12/2011 

  F

tate of Alabama 

   S

Mark Appropriate Court: 

Indicate if Original Charge is:     

Limits 

Attorney Name (Please type or print)  

 

 

________________________________________ 

________________________________________ 
        

Social Security Number or FEIN 

  _

  _

  (cid:133)

  (cid:133)

apital Case (or charge carrying 

 (NO Limit) CC  

sentence of life without parole)  
Class A Felony 
Class B Felony     
Class C Felony 
Other 
Appeal 
Petition for Writ of Certiorari         
Post-Conviction/Habeas Corpus        

 ($3,500) FA  
(cid:133) ($2,500) FB 
(cid:133) ($1,500) FC 
(cid:133) ($1,000) OT 
(cid:133) ($2,000) AP 
(cid:133) ($2,000) WC 
(cid:133) ($1,000) PC      

  C

 Circuit Court of ________________ County  
(cid:133) District Court of________________ County 
(cid:133) Alabama Court of Criminal Appeals 
(cid:133) Alabama Court of Civil Appeals 
(cid:133) Supreme Court of Alabama               

 

 

 
STYLE OF CASE:     ____________________________________________ v. __________________________________________________ 
 
 
NAME OF PARTY REPRESENTED: ____________________________________________________________________________________ 

                                  

        

       

 

 

 

 

 

 

 

 

CHARGE: _________________________________________________________________________________________________________ 

Companion case numbers and charges or convictions: ______________________________________________________________________ 

__________________________________________________________________________________________________________________ 
 

The  undersigned  attorney  declares  that  on  (date)  _____________________________,  the  Honorable  ___________________________________ 
_________________________,  Judge,  appointed  the  undersigned  to  represent  the  above-named  defendant  or  appellant,  and  on  (date) 
___________________ the case was heard by the Honorable _____________________________________________________________, Judge. The 
case was disposed of by _________________________________________________________________________________________________. 
 

             (Plea of guilty, conviction, acquittal, affirmance, reversal, cert. denied)  

   

 

n court Appearance (Trial Level or Post-Conviction Proceeding)  
Out-of-Court Preparation (Trial Level or Post-Conviction Proceeding)  
Preparation (Appellate Level)    
Extraordinary Expenses (If approved in advance by the Court)                                                                                                          ___________________ 
Overhead Expenses (If approved in advance by the Court) 

     Total Hours __________ x   $ 60.00  per hour  = ___________________ 
     Total Hours __________ x   $ 40.00  per hour  = ___________________ 
                     Total Hours __________ x   $ 60.00  per hour  = ___________________ 

                       Total Hours _________ x  $ _______ per hour  =  ___________________     

 

 

NOTICE TO ATTORNEY: Complete this form. Attach a copy of a complete itemization of in-court appearances; out-of-court preparation; preparation for 
appeals; extraordinary expenses; and/or overhead expenses reflecting the date of actions and amount of time involved in each activity. Attach original 
invoice or receipt for all expenses and corresponding court orders.  Make a copy of same for the court’s record and a copy or your records.   
 
The undersigned attorney further declares that the above claim is true and correct and represents the services actually rendered by him/her as an attorney and the 
amount  is  due  and  payable.  I  further  declare  that  the  above  claim  is  not  a  duplication  of  charges  and  expenses  in  any  case  (companion  or  otherwise)  

 

 

 

 

 

 

 

 

 

 

    TOTAL CLAIM OF ATTORNEY                        ______________________ 

 

 

_________________________________________________________________            __________________________________________________________  
Signature of Attorney                                                                                                             Date 

 

 

  

 

Attorney Code _____________________________________________________            
                                                                                                                                                
Mailing Address of Attorney 
(please type or print) (including city, state, and zip code)  

_________________________________________________________________ 

_________________________________________________________________ 

________________________________________________________________ 

-mail Address:_____________________________________  Telephone Number ____________________ Fax Number ______________________ 

, the undersigned judge, hereby certify that the foregoing claim has been presented to me, and I have reviewed the same and believe the same to be 
true and correct.  I am further of the opinion that said attorney is not duplicating said charges and expenses in any case (companion or otherwise).  

ased on the above, I hereby approve the attorney’s declaration and claim in the amount of $_____________________. 

_________________________________________________________________               ____________________________________ 
 Judge’s Signature                                                                                                                     Date 

OTICE TO ATTORNEY AND JUDGE: Sections 15-12-21 through 15-12-23, Ala. Code 1975, provide for the payment of attorney fees and extraordinary 
expenses  incurred  by  counsel  appointed  to  represent  indigent  defendants  at  the  trial  level,  on  appeal  (including  petition  for  writ  of  certiorari  to  the  Alabama 
Supreme Court), and in post-conviction proceedings.  

HIS  FORM  MUST  CONTAIN  ORIGINAL  SIGNATURES  OF  THE  ATTORNEY  AND  THE  JUDGE.  THIS  FORM  WITH  ATTACHED  ITEMIZATION  MUST  BE 
SUBMITTED TO THE TRIAL COURT JUDGE OR PRESIDING JUDGE OR CHIEF JUSTICE OF THE APPELLATE COURT FOR CERTIFICATION, FILED WITH 
THE CLERK, AND THEN SUBMITTED TO THE OFFICE OF INDIGENT DEFENSE SERVICES.  

iled in the Clerk’s Office at _______________________________, Alabama, on __________________________. 

 

 

 

 

 

 

 

          Date 

  MAIL TO: Office of Indigent Defense Services, P.O. BOX 302598 Montgomery, Alabama 36130-2598.  

  (cid:133)

 

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