United States District Court

PREAUTHORIZATION OF PRO BONO ATTORNEY EXPENSES IN CIVIL CASES

Required fields are marked with an asterisk (*).

Attorney Name:*

Street Address:*

City:*

State:*

Zip:*

Email:*

Case Number:*

Case Name:*

Assigned Judge:*

Please be sure to only enter numbers (no commas or dollar signs) in the amount field.

Depositions & Transcripts:

Investigative/Expert Services:

Travel:

Fees for service of Process:

Interpreter Services:

Photocopying, Telephone Calls:

Total Preauthorization Requested:

Please explain in detail why these expenses are necessary in litigating your case: *

Attorney's Name Typed:*

Date:*

Attorney's Signature:

Please enter the following two numbers in reverse order:* 4 6