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i <br /> INSTRUCTIONS FOR COMPLETION OF DEPENDENCY <br /> COURT REPRESENTATION REPORT <br /> This form is to be used to report to the Justice Administrative Commission, expenditures <br /> on expenses and costs of court appointed counsel representing indigent parents at shelter <br /> hearings, 39.013 F.S. <br /> 1.) FISCAL YEAR <br /> a. Fiscal Year of expenditures being reported. <br /> 2.) CIRCUIT <br /> a. Judicial Circuit Number of expenditures being reported. <br /> 3.) MONTH AND YEAR <br /> a. Month and Year of quarter being reported. . <br /> 4.) COUNTY <br /> a. County reporting <br /> 5.) TOTAL DEPENDENCY PETITONS FILED <br /> a. Total dependency petitions filed during reporting period. <br /> 6.) NUMBER ACCEPTED AS INDIGENT <br /> a. Number eligible for court appointed counsel. <br /> 7.) CONTRACT ATTORNEY FEES <br /> a. Total contract Attorney fees expended for Indigent Representation during <br /> this reporting period. <br /> 8.) TYPED NAME: COURT ADMINISTRATOR <br /> a. Typed name of Court Administrator and Telephone Number. <br /> 9.) SIGNATURE: COURT ADMINISTRATOR <br /> a. Signed name of Court Administrator and Date. <br /> 10. PERSON COMPLETING FORM/TITLE <br /> a. Name and Title of person completing form and Date. <br /> \\Snap\Accounting\Child Dependency\Instructions for Completion of Dependency <br /> October 23, 2002 <br />