SUPERIOR COURT CITY AND COUNTY OF SAN FRANCISCO AUTHORIZATION FOR FUNDS FOR APPOINTMENT OF PRIVATE SOCIAL WORKER IN THE MATTER OF: ____________________________________ Minor Case No. ______________________ 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 to exceed $ . SUMMARY OF SOCIAL WORKER TASK: _________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________ Attorney Signature _________________________________ Judge’s Signature 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: Phone: Fax #: DATED: ______________________ SIGNED: ________________________________ Attorney’s Signature DATED: ______________________ SIGNED: ________________________________ Judge’s Signature NOTE: Please submit one (1) original and one (1) copy of the order and all attachments. (LAST REVISED 3/22/05) American LegalNet, Inc. www.FormsWorkflow.com