Superior Court of California, County of San Francisco
UNIFIED FAMILY COURT JUVENILE DEPENDENCY
Authorization for Funds for Appointment of Private Social Worker
IN THE MATTER OF:
Case Number: (Defendant/Minor)
GOOD CAUSE APPEARING, IT IS HEREBY ORDERED that public funds be provided on application by attorney, _________________________________, for the purpose of retaining a private social worker in the above captioned matter, said funds not exceed $ _______________________.
SUMMARY OF SOCIAL WORKER TASKS:
Attorney Signature
Dated:
Commissioner/Judge of the Superior Court
Dated:
ORDER FOR PAYMENT OF COMPENSATION
IT IS HEREIN ORDERED that a warrant for the sum of $ ______________, payable out of the general fund of the City and County of San Francisco be drawn by the City and County of San Francisco in favor of:
NAME: SOCIAL SECURITY NO.: ADDRESS: CITY/STATE/ZIP CODE: TELEPHONE: FAX: Dated: Attorney Signature Date: Commissioner/Judge of the Superior Court
NOTE: Please submit one (1) original and two (2) copies of the order with copies of invoice and any additional attachments.
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AUTHORIZATION FOR FUNDS FOR APPOINTMENT OF PRIVATE SOCIAL WORKER
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