Panel Attorney Circuit Court Criminal Disposition Form

IN THE CIRCUIT COURT OF COUNTY, MISSOURI

Judge or Division:

STATE OF MISSOURI Case Number: vs.

Defendant

1. Case assignment date: Case disposition date:

2. Original Charge[s] Charges at disposition:

3. Disposition by: Plea Trial Dismissal Private entry NGRI

4. If by plea, please indicate final terms of plea agreement:

5. If trial, number of days of trial Date new trial motion filed: Date you filed the Notice of Appeal:

6. Please list all defense motions filed whether case was tried or not:

7. Were depositions taken in the case: Yes No

8. Were any experts used or consulted in the case: Yes No

9. How many times did you talk to the client by telephone and by personal visit

10. Please summarize all investigative work done on the case including the names of all potential state and defense witnesses contacted:

11. Did you visit the alleged crime scene: Yes No

12. Did you secure a lien for services with the court and returned it to MSPD: Yes No

13. Do you have any comments about this case disposition or this panel attorney contract:

______Panel Attorney Date