Video Conference Prison Claim

• Published date: 12 February 2019
• Issuer: Department of Justice

Criminal Legal Aid

Video Conference / Prison Claim

Date of Video Conference: Video Link From:

To:

Solicitor:

Barrister:

PAYEE No.:

PAYEE No.:

Client’(s) Name (s): Bill No (s): Free L.A. No (s):

Prisoner’(s) No:

Claimant’s Declaration:

I declare that the particulars given by me above are correct and that no other claims are being submitted for this video

conference session. I further declare that this video conference was essential to the preparation and conduct of the

person’s defence, appeal or case stated as maybe:

Solicitor’s Signature …………………………………………………………………………. Date: ………………………………….

Barrister’s Signature …………………………………………………………………………. Date: ………………………………….

Prison Certificate:

I declare that the above names Solicitor / Barrister

consulted the above named inmate(s) by Video

Conference on this date during the time band opposite.

Governor’s Signature: ……………………………………..

Date: ……………………………………..

Time Band (Please tick appropriate band)

Prison Stamp:

10 to 12 AM 2 to 4 PM 5 to 7 PM

This form, when completed at the place of detention, should be forwarded directly to:

The Accountant, Department of Justice and Equality, Climinal Legal Aid Payments Section,

Financial Shared Service Facility, Deerpark Road, Killarney, Co. Kerry.

AH3140v

Form C.L.A.11(B)

AN ROINN DLÍ AGUS CIRT AGUS COMHIONANNAIS

DEPARTMENT OF JUSTICE AND EQUALITY