Report Pro Bono Hours Please enable JavaScript in your browser to complete this form.Attorney Name:FirstLastClient's Name *FirstLastHeartland File Number: 2021 pro bono hours: *If you don't know the exact number of hours, an estimate is fine. Case is: *Still OpenClosed during 2021Closed during 2022If closed in 2022, number of 2022 pro bono hours: If closed, why was it closed? Matter was resolved.Client failed to contact me.Client failed to cooperate.Terminated by client.No merit / moot.Client not eligible for pro bono services.Other (please describe in notes)Services provided (closed cases ONLY): NoneCounsel & advice onlyLimited ActionExtensive service without settlement or court orderAdministrative agency decisionCourt decision (uncontested)Court decision (contested)Negotiated settlement with litigationNegotiated settlement without litigationOther (please describe in notes)If closed, have you withdrawn your appearance?YesNot yet, but I willNot applicable / did not file appearanceHas another party agreed or been ordered to pay any of your fees or costs?No.Yes (please describe in notes)Heartland Pro Bono appreciates pro bono services provided by its volunteers. It is therefore Heartland’s policy to provide limited reimbursement for actual reasonable out-of-pocket expenses when funds are available. If you would like to be reimbursed for eligible expenses. please submit an Expense Reimbursement Request. Did you have any out-of-pocket expenses (e.g., filing, service, medical records, etc.)? No.Yes, and I would like to be reimbursed. **Please submit a Reimbursement RequestYes, but I am not asking for reimbursement.Are you willing to accept another case from Heartland? *Yes!Not right now; check back later (please provide followup date in notes)No, thank you.Additional comments, concerns, or questions about this referral: EmailSubmit
