Attorney Hours Report Form

Reporting Period Year: Please enter reporting period:: January - June
July - December
Other
Total number of volunteer hours during this reporting period:

Please complete the chart below for your case: Client: Approximate date case was opened:
(XX / XX / XXXX) Approximate date case was closed:
(XX / XX / XXXX) Total number of hours expended during reporting period: Status - please check all that apply: Case is ongoing.
Case is closed.
Client is unresponsive.
Case is on appeal.
I would like CLC to assign a new attorney.
Any milestones reached? (please describe):

Please provide your hourly billing rate. We must assign a dollar value to the number of hours we report as having been volunteered. Neither your name nor your firm will be disclosed. Hourly rate:
($XXX.XX)

Contact Information First Name: Last Name: Firm: Street Address: City: State: Zip: Email Address: Phone:
(XXX)-XXX-XXXX

Acknowledgement

I hereby certify that I am not currently subject to disciplinary proceedings under the Maryland Rules of Procedure and that I am admitted to practice before the Maryland Court of Appeals. I will notify the Bar Association of Baltimore City and Community Law Center, Inc. if I am suspended or disbarred from the practice of law in Maryland.