United States District Court
Middle District of Florida

CJA eVoucher Vendor Access Form

Use this form to request access to the CJA eVoucher system as
a vendor, expert, or court reporter.

* denotes a required field

Personal Information

First Name:

Middle Name:

Last Name:

List your current MDFL CJA appointed cases

List the hiring attorneys

Specialties:

Accountant
Ballistics Expert
CALR(Westlaw, Lexis, etc)
Chemist, Toxicologist
Computer (Hardware, Software, Systems)
Computer Forensics Expert
Court Reporter
Documents Examiner
Duplication Services
Fingerprint Analyst
Hair, Fiber Expert
Interpreter Translator
Investigator
Jury Consultant
Legal Analyst/Consultant
Litigation Support Services
Mitigation Specialist
Other
Other Medical Expert
Paralegal Services
Pathologist, Medical Examiner
Polygraph Examiner
Psychiatrist
Psychologist
Voice, Audio Analyst
Weapons Firearms Explosive Expert

Phone Number:

nnn-nnn-nnnn *

Cell Number:

nnn-nnn-nnnn

Primary E-mail:

Your login and password will be sent to the e-mail address entered above. You must enter a valid e-mail address in order to obtain eVoucher access.

Additional E-mail:

If you would like a notice sent to another e-mail address, in addition to your primary e-mail address, please enter it in the field above.

Single Login Profile E-mail:

If you have an existing eVoucher account in another district or circuit, provide the email used for your Single Login Profile in the field above.
(Tip: This information can be found in eVoucher by clicking "Single Login Profile" in the top right hand corner under your name.)

W-9 Form:

Please select "Choose File" to upload your W-9 form as a PDF file in the field above.

CV:

Please select "Choose File" to upload your CV as a PDF file in the field above.

Certificate:

Please select "Choose File" to upload any applicable certificate as a PDF file in the field above.

Contact Information - Mailing Address

Company Name:

Address 1:

Address 2:

City:

State:

Mailing Address Zip + 4

Please enter the number that appears below:

Please click here for an audio version of the number.

You will receive an email within five to seven business days.

Date

Vendor/Participant Signature

Type your full name, prefixed with "s/", in the field above to acknowledge that you have read and understand the information in this document.