Opd E 205 Form PDF Details

Are you a healthcare provider looking to better understand the OPD E 205 Form? If so, this blog post is written just for you. In this article, we’ll break down everything there is to know about the OPD E 205 form – from what it entails and when it’s used, to how to properly complete and submit it. With our comprehensive guide at hand, you can be sure that submitting your information for reimbursement will go as smoothly as possible!

QuestionAnswer
Form NameOpd E 205 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesOhio, attests, CERTIFICATION, opd e 205

Form Preview Example

CLERK’S/AUDITOR’S TRANSCRIPT FEE FOR AN INDIGENT DEFENDANT

Revised Code 2301.24­25

In the ______________________________________Court of _______________________________________,Ohio.

Plaintiff:

 

Case No. __________________________________

v.

Attorney(s) for the Defendant/Party Represented:

____________________________________________

 

Defendant/Party Represented

__________________________________________

In re:________________________________________

__________________________________________

CLERK OF COURTS CERTIFICATION

I, the Clerk of Courts, hereby certify that _______________________________, __________________________,is

(Court Reporter’s Name)

(Court Reporter’s Tax ID)

hereby an official stenographer of said court and is entitled to the following fees for making transcript(s) of:

_________________________________________________________________________________________________

____________________________________________

____________________________________________

 

Clerk’s Signature

 

 

Date

The transcript is ordered by the court for use by the Defendant or the Defendant’s attorney in the following type of

proceeding:

 

 

 

_____

Felony, misdemeanor, or juvenile proceeding

_____

Capital Offense trial proceeding

_____

Appeals proceeding

_____

Capital Offense appeals proceeding

_____

Postconviction proceeding

_____

Capital Offense postconviction proceeding

_____

Other (explain) __________________________________________________________

Date which above checked proceeding terminated: ____________________ OR

Still Pending (check if pending)

 

 

 

 

_______________

Original transcript of ____________ pages or folio at the rate of $____________ per page or folio,ζψξ= $

Copy of transcript of ____________ pages or folio at the rate of $____________ per page or folio, = $_______________

 

 

 

 

TOTAL $_______________

NOTE: A COPY OF THE COURT REPORTER’S BILLING MUST BE ATTACHED

JUDGMENT ENTRY

The court finds that the transcript was ordered for use in the case of an Indigent person, that all rules and standards of the Ohio Public Defender Commission and State Public Defender have been met and that an Affidavit of Indigency/ Financial Disclosure for the above referenced client has been sent to the Office of the Ohio Public Defender or is attached to this document.

IT IS THEREFORE ORDERED that the transcript fees be, and are hereby approved in the amount of $___________________. It is further ordered that the said amount be, and hereby is, certified by the Court to the

County Auditor for payment.

_______________________________________

______________________________________________________

Judge’s Name (type or print)

Judge’s Signature

Date

AUDITOR’S CERTIFICATION

The County Auditor in executing this certificate attests that the transcript was a true and accurate expense of said

county’s court.

County Number _______________

Warrant Number _______________

Warrant Date ________________

 

_________________________________________________

OPD­E­205 Rev. (11/96)

County Auditor’s Signature