Domestic Violence/50B Case Closure Report

We deeply appreciate all the time and effort you put into your pro bono case! Please complete this form with your pro bono hours and the result of the concluded case. We are particularly interested to hear how you may have helped to achieve meaningful results for your client, as well as details about your own experiences during the case. Thank you! If you have any questions or concerns, please contact:

Katie Russell Miller, Director of the MAVL Program – TEL: (828) 210-3420 – FAX: (828) 252-8927

Domestic Violence/50B Case Closure Report

Client Name*
First Last
Attorney Name*
First Last
Date Case Closed
MM slash DD slash YYYY
Pro Bono Time by Activity
Please choose the type of activity and then enter the date completed and the time spent below.
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Date Completed Time Spent
Total Pro Bono Time:
Results of Representation
Please select all that apply.
- Obtained/ Enforced Civil Protective Order (3701)
- Prevented Other Abuse Related to DV (3703)
- Obtained Victim Compensation (3706)
- Prevented Abuse of a Child (3702)
- Prevented Abuser from Possessing Firearms (3704)
- Defended Victim Against Improper Protective Order (3707)
- Other Results - please explain below
Experience
(we appreciate any feedback you provide regarding your experience, whether personal or professional):

Domestic Violence/50B Case Closure Report

Domestic Violence/50B Case Closure Report

Pro Bono Time by Activity

Results of Representation

Experience