Santa Clara — FM-1110*

Source: https://santaclara.courts.ca.gov/system/files/forms/fm-1110_rem.pdf

ATTACHMENT FM-1110 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA FOR COURT USE ONLY STREET ADDRESS: 201 North First Street, San José, CA 95113 MAILING ADDRESS: 191 North First Street CITY AND ZIP CODE: San José, California 95113 BRANCH NAME: Family Justice Courthouse

PETITIONER:

RESPONDENT:

OTHER PARENT/ CLAIMANT:

APPLICATION AND ORDER FOR EXPERT WITNESS FEES CASE NUMBER:
(FAMILY CODE SECTION 3112)
DEPARTMENT NUMBER:
APPLICATION AND ORDER FOR DEPOSITION FEES
(GOVERNMENT CODE SECTION 68096.1(d)) FCS NUMBER:

APPLICATION

I, , declare under penalty of perjury, as follows:

1. I am an Evaluator/Screener for the Superior Court of California, County of Santa Clara Family Law Division.

2. I have been ordered by the Court to perform an evaluation/screening involving custody and visitation

investigation in the above listed matter and, in conjunction with such evaluation I have been required to provide

testimony as an expert witness on .

3. The assessed fee for such testimony is $160.00 per hour. I spent hours testifying. The total

   cost for the testimony is $ .

Dated: Signed: Screener/Evaluator

ORDER

IT IS ORDERED that:

1. Each party shall pay $ , which is one half of the Family Court Services fee. The fees are due and

   payable within 30 days from the service of this Order, unless a fee waiver of these specific fees in granted.

2. Other Orders:

Dated: Judicial Officer

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