ATTACHMENT FM-1110
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS: 201 North First Street, San José, CA 95113
MAILING ADDRESS: 191 North First Street
CITY AND ZIP CODE: San J
osé, California 95113
BRANCH NAME: Family Justice Courthouse
FOR COURT USE ONLY
PETITIONER:
RESPONDENT:
OTHER PARENT/ CLAIMANT:
APPLICATION AND ORDER FOR EXPERT WITNESS FEES
(FAMILY CODE SECTION 3112)
APPLICATION AND ORDER FOR DEPOSITION FEES
(GOVERNMENT CODE SECTION 68096.1(d))
CASE NUMBER:
DEPARTMENT NUMBER:
FCS NUMBER:
APPLICATION
I, , declare under penalty of perjury, as follows:
1. I am an Evaluator/Screener for the Superior Court of California, County of Santa Clara Family Law Division.
2. I have been ordered by the Court to perform an evaluation/screening involving custody and visitation
investigation in the above listed matter and, in conjunction with such evaluation I have been required to provide
testimony as an expert witness on .
3. The assessed fee for such testimony is $160.00 per hour. I spent hours testifying. The total
cost for the testimony is $ .
Dated: Signed:
Screener/Evaluator
ORDER
IT IS ORDERED that:
1. Each party shall pay $ , which is one half of the Family Court Services fee. The fees are due and
payable within 30 days from the service of this Order, unless a fee waiver of these specific fees in granted.
2. Other Orders:
Dated:
Judicial Officer
FM-1110 NEW 07/01/11
EXPERT WITNESS FEE APPLICATION
Page 1 of 1
