BILL OF COSTS TEXAS COURT OF APPEALS, SIXTH DISTRICT, AT TEXARKANA No. 06-15-00076-CV Texas Health and Human Services Commission and Office of Inspector General v. Antoine Dental Center (No. D-1-GN-14-002229 IN 200TH DISTRICT COURT OF TRAVIS COUNTY)

TYPE OF FEE CHARGES PAID BY MOTION FEE $10.00 E-PAID JASON RAY CLERK'S RECORD $488.00 PAID HHSC REPORTER'S RECORD $455.50 UNKNOWN HHSC FILING $100.00 TRANSFER RHONDA RODRIGUEZ STATEWIDE EFILING FEE $30.00 TRANSFER RHONDA RODRIGUEZ INDIGENT $25.00 TRANSFER RHONDA RODRIGUEZ SUPREME COURT CHAPTER 51 FEE $50.00 TRANSFER RHONDA RODRIGUEZ

Balance of costs owing to the Sixth Court of Appeals, Texarkana, Texas: 0.00 Court costs in this cause shall be paid as per the Judgment issued by this Court.

I, DEBRA AUTREY, CLERK OF THE SIXTH COURT OF APPEALS OF THE STATE OF TEXAS, do hereby certify that the above and foregoing is a true and correct copy of the cost bill of THE COURT OF APPEALS FOR THE SIXTH DISTRICT OF TEXAS, showing the charges and payments, in the above numbered and styled cause, as the same appears of record in this office.

IN TESTIMONY WHEREOF, witness my hand and the Seal of the COURT OF APPEALS for the Sixth District of Texas, this June 23, 2016.

DEBRA AUTREY, CLERK

By ___________________________ Deputy