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Get IN Request for Reimbursement of Expenses 2007-2024

N: Requesting Entity: Date of Remand for New Trial: Trial Court Prosecuting Attorney Public Defender Check ONLY one Type of Expense Vendor-Address Date Incurred Amount Use Additional Sheets if Necessary I affirm under the pains and penalties for perjury that: 1) the above listed expenses were incurred by the trial court, prosecuting attorney or public defender representing the defendant (circle ONLY one) in conducting a new trial of the defendant following a remand by the Indiana Sup.

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