CJA 31 DEATH PENALTY PROCEEDINGS: EX PARTE REQUEST FOR AUTHORIZATION AND VOUCHER EXPERT AND OTHER SERVICES (Rev. 5/99)
1. CIR./DIST./ DIV. CODE	2. PERSON REPRESENTED	VOUCHER NUMBER
3. MAG. DKT./DEF. NUMBER	4. DIST. DKT./DEF. NUMBER	5. APPEALS DKT./DEF. NUMBER	6. OTHER DKT. NUMBER
7. IN CASE/MATTER OF (Case Name)	8. TYPE PERSON REPRESENTED	9. REPRESENTATION TYPE
□	Adult Defendant	□	Appellant	□	Other	□ Z	D1 28 U.S.C. § 2254 Habeas (Capital)	□	D3 28 U.S.C. § 2255 (Capital)
□	Habeas Petitioner	□	Appellee	□	D2 Federal Capital Prosecution	□	D4 Other (Specify)
10. OFFENSE(S) CHARGED (Cite U.S. Code, Title & Section) If more than one offense, list (up to five) major offenses charged, according to severity of offense.
REQUEST AND AUTHORIZATION FOR EXPERT SERVICES
11. ATTORNEY'S STATEMENT
As the attorney for the person represented, who is named above, I hereby affirm that the services requested are necessary for adequate representation. I hereby request:
□	Authorization to obtain the service. Estimated Compensation and Expenses:	OR
□	Approval of services already obtained to be paid for by the United States pursuant to the Criminal Justice Act. (See Instructions)
Signature of Attorney	Date
□	Panel Attorney	□	Retained Attorney	□	Pro-Se	□	Legal Organization
ATTORNEY'S NAME (First Name, M.I., Last Name, including any suffix), AND MAILING ADDRESS
Telephone Number:
12. DESCRIPTION OF AND JUSTIFICATION FOR SERVICES (See Instructions)	13. TYPE OF SERVICE PROVIDER
01	□	Investigator	15	□	Other Medical
02	□	Interpreter/Translator	16	□	Voice/Audio Analyst
03	□	Psychologist	17	□	Hair/Fiber Expert
04	□	Psychiatrist	18	□	Computer (Hardware/
05	□	Polygraph	Software/Systems)
14. COURT ORDER	Financial eligibility of the person represented having been established to the Court's	06	□	Documents Examiner	19	□	Paralegal Services
satisfaction, the authorization requested in Item 11 is hereby granted.	07	□	Fingerprint Analyst	20	□	Legal Analyst/Consultant
08	□	Accountant	21	□	Jury Consultant
Signature of Presiding Judicial Officer or By Order of the Court	09	□	CALR (Westlaw/Lexis, etc.)	22	□	Mitigation Specialist
10	□	Chemist/Toxicologist	23	□	Duplication Services
Date of Order	Nunc Pro Tunc Date	11	□	Ballistics	(See Instructions)
Repayment or partial repayment ordered from the person represented for this service at time of authorization.	13	□	Weapons/Firearms/Explosive Expert	24	□	Other (Specify)
□	YES	□	NO	14	□	Pathologist/Medical Examiner
15. STAGE OF PROCEEDING	Check the box which corresponds to the stage of the proceeding during which the work claimed at Item 16 was performed even if the work is intended to be used in connection with a later stage of the proceeding. CHECK NO MORE THAN ONE BOX. Submit a separate voucher for each stage of the proceeding.
CAPITAL PROSECUTION	HABEAS CORPUS	OTHER PROCEEDING
a.	□	Pre-Trial	e.	□	Appeal	g.	□	Habeas Petition	k.	□	Petition for the	l.	□	Stay of Execution	o.	□	Other
b.	□	Trial	f.	□	Petition for the	h.	□	Evidentiary Hearing	U.S. Supreme Court	m.	□	Appeal of Denial of Stay
c.	□	Sentencing	U.S. Supreme Court	i.	□	Dispositive Motions	Writ of Certiorari	n.	□	Petition for Writ of Certiorari to the U.S.
d.	□	Other Post Trial	Writ of Certiorari	j.	□	Appeal	Supreme Court Regarding Denial of Stay
CLAIM FOR SERVICES AND EXPENSES	FOR COURT USE ONLY
16.	SERVICES AND EXPENSES

(Attach itemization of services with dates)	AMOUNT CLAIMED	MATH/TECHNICAL

ADJUSTED AMOUNT	ADDITIONAL

REVIEW
a. Compensation
b. Travel Expenses (lodging, parking, meals, mileage, etc.)
c. Other Expenses
GRAND TOTALS (CLAIMED AND ADJUSTED):
17. PAYEE'S NAME (First Name, M.I., Last Name, including any suffix), AND MAILING ADDRESS

TIN:
Telephone Number:
CLAIMANT'S CERTIFICATION FOR PERIOD OF SERVICE FROM	TO
CLAIM STATUS	□	Final Payment	□	Interim Payment Number	□	Supplemental Payment
I hereby certify that the above claim is for services rendered and is correct, and that I have not sought or received payment (compensation or anything of value) from any other source for these services.
Signature of Claimant/Payee	Date
18. CERTIFICATION OF ATTORNEY I hereby certify that the services were rendered for this case.
Signature of Attorney	Date
APPROVED FOR PAYMENT — COURT USE ONLY
19. TOTAL COMPENSATION	20. TRAVEL EXPENSES	21. OTHER EXPENSES	22. TOTAL AMOUNT APPROVED/CERTIFIED
23.	□	Either the cost (excluding expenses) of these services does not exceed $300, or prior authorization was obtained; OR
□	In the interest of justice the Court finds that timely procurement of these necessary services could not await prior authorization, even though the cost (excluding expenses) exceeds $300.
Signature of Presiding Judicial Officer	Date	Judge/Mag. Judge Code
24. TOTAL COMPENSATION	25. TRAVEL EXPENSES	26. OTHER EXPENSES	27. TOTAL AMOUNT APPROVED
28. FOR REPRESENTATIONS COMMENCED AND APPELLATE PROCEEDINGS IN WHICH AN APPEAL IS PERFECTED ON OR AFTER APRIL 24, 1996,
A.	Total compensation and expense payments approved to date (include amounts withheld for interim payments) for investigative, expert and other services for this
representation is $
B.	Payment approved (compensation and expenses) in excess of the statutory threshold for investigative, expert and other services under 21 U.S.C. § 848(q)(10)(B).
Signature of Chief Judge, Court of Appeals (or Delegate)	Date	Judge Code