ADM-124 Screeing Investigation Billing Forms (6-11): Fill out & sign online

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Click ‘Get Form’ to open the ADM-124 Screening Investigation Billing Form in the editor.
Begin by filling out the 'Case Information' section. Enter the Respondent's name, Case Number, and Judicial Officer details accurately.
Next, move to the 'Provider Information' section. Input your Name, Phone number, and Address. Ensure that your Company name and Tax ID No. are also included.
In the 'Screening Investigation' area, record the Date of Appointment and Date of Screening Report. List all Services Provided; if necessary, use additional sheets for more entries.
Document the Time spent on each service in tenths of hours and enter the total Amount Submitted for Payment at the bottom of this section.
Finally, certify your services by signing and dating the form in the designated area before submitting it for court approval.

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