Fillable Court Investigator Certificate Of Services Itemization Jv 116re (Commonwealth of Massachusetts)

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Court Investigator Certificate Of Services Itemization Jv 116re (Commonwealth of Massachusetts)

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JV-116 (06/02/2014)
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:
JV-116 (06/02/2014)
COURT INVESTIGATOR'S
ITEMIZATION OF SERVICES Page of
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
CASE NAME
VENDOR CODE NUMBER
DIVISION
ITEMIZATION OF SERVICES
(shall not include travel nor time for preparation of this form)
DATE OF
SERVICE
START TIME/
END TIME
TIME SPENT
(In Minutes)
DESCRIPTION OF WORK
(Please Specify)
Total Minutes:
DATE SIGNATURE OF COURT INVESTIGATOR
Total Minutes Divided by 60 = Hours
X $30.00 per hour = Total Amount: $
ATTACH THE FOLLOWING: A COPY OF APPOINTMENT, A COPY OF THE REPORT AND A COPY OF ANY APPROVED MOTION(S).
FAILURE TO PROVIDE THE REQUIRED ATTACHMENTS WILL DELAY PROCESSING OF THIS FORM FOR PAYMENT.
PRINT NAME
2
JV-116 (06/02/2014)
COURT INVESTIGATOR'S
ITEMIZATION OF SERVICES Page of
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
CASE NAME
VENDOR CODE NUMBER
DIVISION
ITEMIZATION OF SERVICES
(shall not include travel nor time for preparation of this form)
DATE OF
SERVICE
START TIME/
END TIME
TIME SPENT
(In Minutes)
DESCRIPTION OF WORK
(Please Specify)
Total Minutes:
DATE SIGNATURE OF COURT INVESTIGATOR
Total Minutes Divided by 60 = Hours
X $30.00 per hour = Total Amount: $
ATTACH THE FOLLOWING: A COPY OF APPOINTMENT, A COPY OF THE REPORT AND A COPY OF ANY APPROVED MOTION(S).
FAILURE TO PROVIDE THE REQUIRED ATTACHMENTS WILL DELAY PROCESSING OF THIS FORM FOR PAYMENT.
PRINT NAME
3
JV-116 (06/02/2014)
COURT INVESTIGATOR'S
ITEMIZATION OF SERVICES Page of
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
CASE NAME
VENDOR CODE NUMBER
DIVISION
ITEMIZATION OF SERVICES
(shall not include travel nor time for preparation of this form)
DATE OF
SERVICE
START TIME/
END TIME
TIME SPENT
(In Minutes)
DESCRIPTION OF WORK
(Please Specify)
Total Minutes:
DATE SIGNATURE OF COURT INVESTIGATOR
Total Minutes Divided by 60 = Hours
X $30.00 per hour = Total Amount: $
ATTACH THE FOLLOWING: A COPY OF APPOINTMENT, A COPY OF THE REPORT AND A COPY OF ANY APPROVED MOTION(S).
FAILURE TO PROVIDE THE REQUIRED ATTACHMENTS WILL DELAY PROCESSING OF THIS FORM FOR PAYMENT.
PRINT NAME
4
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Court Investigator Certificate Of Services Itemization Jv 116re (Commonwealth of Massachusetts)

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Completed 27 July 2020

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