Application to Serve as Assigned Counsel

Payment of Appointed Counsel
Fees and Expenses

Attorneys must complete the Motion, Entry, and Certification for Appointed Counsel Fees form and send it to your appointing judge for payment of fees and expenses. In addition, please send your completed IRS Form W-9 to brhelr@cmcoh.org.

Home > Judicial Services > Magistrates > Application to Serve as Assigned Counsel

Contact Information

NAME *

BUSINESS ADDRESS *

EMAIL ADDRESS *

BUSINESS PHONE *

CELL PHONE *

Registration

ADMITTED TO OHIO BAR *

REGISTRATION NUMBER *

Certifications

I HAVE READ THE QUALIFICATIONS AND I QUALIFY FOR INCLUSION TO HANDLE GENERAL MISDEMEANORS. ADDITIONALLY, BY CHECKING THE BOX BELOW, I CERTIFY THAT I HAVE THE QUALIFICATIONS TO HANDLE OVIs.

Misdemeanor

Requirements include: A minimum of six CLE credit hours focused on OVI practice and procedure within two years prior to appointment (Ohio Administrative Code 120-1-10).

Cases

CASE 1

CASE 2

CASE 3

ATTACHMENT: PROOF OF INSURANCE

Document must include expiration date of coverage, showing that insurance coverage is current.

ATTACHMENT: MOST RECENT CLE TRANSCRIPT FOR CRIMINAL PRACTICE AND PROCEDURE

Confirmation

I HEREBY STATE THAT THE FACTS CONTAINED ABOVE ARE TRUE.

If you have any questions, please call 216-664-4701.

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