Equal Access to Justice Act Form

Legal Form Number5
CourtU.S. Claims Court
SectionCourt of Federal Claims
198
Form 5
Equal Access to Justice Act Form
APPLICATION
FOR FEES AND OTHER EXPENSES UNDER THE EQUAL ACCESS TO JUSTICE ACT
1. COURT:
U.S. Court of Federal Claims
2. DATE FILED:
3. DOCKET NO.:
4. NAME OF APPLICANT:
(one per form)
5. GOVERNMENT AGENCY INVOLVED IN
CLAIM: (use agency code on reverse side)
6. NATURE OF APPLICATION:
A. Original application under 28 USC§2412(d)(1)(A)
after judgment in a civil action against the U.S.
B. Appeal of fees and expenses awarded by Lower
Court, (If Item 6B is checked, go to Item 7).
C. Original application under 28 USC§2412(d)(3)
after review of agency decision.
D. Petition for leave to appeal an administrative
agency fee determination under 5 USC§504(c)(2).
7. APPEAL FROM:
DISTRICT COURT BANKRUPTCY COURT
OTHER:
7A. DATE FILED IN LOWER COURT:
7B. DOCKET NO.
8. ADMINISTRATIVE
AGENCY DOCKET NO:
9. DATE FILED IN
ADMINISTRATIVE AGENCY:
10. SHOWING OF PREVAILING PARTY
STATUS (28 USC § 2412(d)(1)(B)):
IS AGENCY ORDER, COURT ORDER, OR OTHER RELEVANT DOCUMENT ATTACHED? YES NO
11. SHOWING OF ELIGIBILITY (28 USC § 2412(d)(2)(B)):
IS NET WORTH INFORMATION ATTACHED? YES NO
12. ENTER ALLEGATION THAT
GOVERNMENT POSITION WAS NOT
SUBSTANTIALLY JUSTIFIED
(28 USC § 2412(d)(1)(B)):
13. FOR EACH AMOUNT CLAIMED, PLEASE ATTACH ITEMIZATION INFORMATION INDICATING
SERVICE PROVIDED, DATE, HOURS, AND RATE (28 USC §2412(d)(2)(A)):
AMOUNT CLAIMED
A. ATTORNEY FEES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________
B. STUDY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
C. ANALYSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
D. ENGINEERING REPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
E. TEST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
F. PROJECT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________
G. EXPERT WITNESS FEES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________
H. OTHER FEES AND EXPENSESSPECIFY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
1. _________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
2. _________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
3. _________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
I. TOTAL FEES AND EXPENSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________
14. SIGNATURE:
15. DATE:

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