JV-164 (Rev. 10/01/2018)
COURT INVESTIGATOR'S
CERTIFICATE OF SERVICES Page 1
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
CASE NAME
VENDOR CODE NUMBER
DIVISION
NAME & ADDRESS OF COURT INVESTIGATOR NAME OF APPOINTING JUSTICE
CERTIFICATION OF COURT INVESTIGATOR
I certify under the pains and penalties of perjury that I have performed the services described in the
attached Court Investigator Itemization of Services and that the services and time were necessary
and were within the scope of the services for which I have been appointed by the Court to perform.
I further certify that I have filed the original report with the Court as required and have also attached a
copy of the report to this form.
SIGNATURE OF COURT INVESTIGATORDATE
CERTIFICATION OF JUSTICE
I have reviewed and approve as appropriate the above named court investigator's attached itemization
of services for payment.
DATE SIGNATURE OF JUSTICE
Telephone Number: