Superior Court of California,
County of San Francisco
AUTHORIZATION FOR FUNDS FOR APPOINTMENT OF PRIVATE SOCIAL WORKER
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 Commissioner/Judge of the Superior Court
Dated:
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.
To protect your privacy, clear the data from this form after printing.
