STANISLAUS COUNTY SUPERIOR COURT ______________________________ In the Matter of: ) ) ) ______________________________) Case No.:_______________ DECLARATION AND ORDER FOR ATTORNEY FEES/RECAPITULATION "FAMILY/PROBATE FEE CLAIM" The undersigned attorney, who is duly licensed to practice law in California, declares that on _______________ the Honorable _____________________ presiding, appointed the undersigned under: Family Code §7861/2 Family Code §3150 or Probate Code §1470 to represent ____________________ minor(s) parent, and on ___________, the final disposition of the case was made before the Honorable ___________________ presiding. The undersigned states that he has performed the legal services and incurred the expenses listed in this Declaration as follows, and which were reasonable and necessary. Description of Activity or Time Sheet No. Date Time in 1/10 1. 2. 3. Total __________ X $____________ = ____________ I have received payment of $ __________ on this case. (List additional information to this order on reverse side or as attachments.) I declare under penalty of perjury that the foregoing, including any attachments, is true and correct. Executed on ____________________, at Modesto, California. Print Name: ________________________ Telephone No.:__________________________ _______________________________________ _________________________________ _______________________________________ Declarant's Signature Address ORDER Pursuant to the above declaration and the information provided therein, attorneys fees and costs are hereby awarded to the declarant in the sum of $_______________. The Court is hereby directed to make said payment to the above declarant. Dated: _______________ ___________________________________________ Judge of the Superior Court/Superior Court Administrator SAP CODING STRIP For 3150 CODE _______________________ SAP DOCUMENT NUMBER VENDOR NUMBER:_______________________ COST CENTER Line 1 Line 2 Line 3 502550 502550 502550 G/L DESCRIPTION Children Parents/Guardian CAC Sec 3150 110001 FUND 50 PLANT INV NO:____________________ G/L ACCOUNT 938801 938802 938803 AMOUNT ________________________________Approved for Payment G007 (Mandatory Form) Rev 06/11 American LegalNet, Inc. www.FormsWorkFlow.com