Tion Date of Appointment: Date of Screening Report: Services Provided (please use additional sheets if necessary): 1. 2. 3. 4. 5. Time (in tenths of hours) Amount Submitted for Payment $ I certify that my services in this case are completed and the facts stated above are true to the best of my knowledge and belief. Date Provider Signature FOR COURT USE ONLY Amount approved: $ Date ADM-124 (8/14)(cs) SCREENING INVESTIGATION BILLING FORM Lisa M. Fitzpatrick Administrative Attorney AS 47.
Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save
How to fill out the AK ADM-124 online
The AK ADM-124 is a straightforward form designed for submitting billing information related to screening investigations within the Alaska court system. This guide will assist users through each section of the form to ensure accurate and complete submission online.
Follow the steps to fill out the AK ADM-124 form accurately.
- Press the ‘Get Form’ button to access the form and open it in your preferred editor.
- In the 'Case Information' section, enter the respondent's name, the case number, and the name of the judicial officer overseeing the case.
- Next, move to the 'Provider Information' area. Fill in your name, phone number, and address.
- Continue by providing your company name and tax ID number.
- In the 'Screening Investigation' section, fill out the date of your appointment and the date you completed the screening report.
- List the services provided, using additional sheets if necessary to accommodate all services rendered. Number each service (1, 2, 3, etc.).
- Next, input the time spent on the services in tenths of hours.
- Then, state the total amount you are submitting for payment.
- Finally, certify your services by signing the form and dating it.
- Once all fields are completed, you can save your changes, download the form, print it, or share it as needed.
Complete your forms online today for a smoother submission process!
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Related content
ADM-122 Billing Form for Post-Trial Juror Counseling; ADM-124 Screening Investigation...
Dec 8, 2011 — ADM. FLRIFLR2 ||FLR3. Roof. Building. Administration Utility. AS126...
Sep 21, 2009 — devendo ser apresentadas à administração tributária, quando...
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down process here.