San Francisco — Reporter's Certificate of Completion and Request for Dispersement of Funds

Source: https://sf.courts.ca.gov/system/files/sfacc-001-reporters-certificate-completion-and-request-disbursing-funds_0.pdf

Superior Court of California COUNTY OF SAN FRANCISCO

400 McAllister Street, San Francisco, CA 94102 Phone: 415-551-4000 | Website: https://sfsuperiorcourt.org

REPORTER’S CERTIFICATE OF COMPLETION AND REQUEST FOR DISBURSING FUNDS

(PURSUANT TO APPELLATE RULES, CRC 8.130 and CRC 8.834)

Name of Claimant (please print): Address of Claimant: E-mail Address of Claimant: Case Number: Case Name: Receipt Number: Date Transcript(s) Filed with San Francisco Superior Court (required): Date Appeal was Abandoned or Dismissed: Amount Requested for Payment: Amount Requested for Return to Depositor: Additional Funds to be Paid by Depositor (if applicable):

I hereby certify under penalty of perjury that I have prepared and/or filed the Reporter’s Transcript on Appeal in the above-entitled case as required by the Rules on Appeal; that there was the deposited sum of $ for my portion of Reporter’s Transcript on Appeal, a copy of the Clerk’s notice to reporter to prepare transcript of same being attached hereto.

CHOOSE AND COMPLETE ONE:

☐ I hereby request the sum of $ to be paid to me as per the attached invoice and that the balance of $ be returned to the depositor.

☐ I hereby request the sum of $ to be paid to (Vendor’s Name) as per the attached invoice and that the balance of $ be returned to the depositor. (Note: Must attach copy of Vendor’s W-9 Form.)

Date: Signature of Claimant

Send completed form with your invoice and a copy of the Clerk’s notice to reporter to prepare transcript attached to: San Francisco Superior Court, 400 McAllister Street, Room 205, San Francisco, CA 94102, Attn: Accounting Dept.

FOR COURT USE ONLY

☐ Approved ☐ Denied Reason: ☐ Additional Funds to be Paid by Depositor:

Attention: Accounting | 400 McAllister Street, Room 205, San Francisco, CA 94102 | ARevenue@sftc.org | Fax 415-551-5701

SFACC-001 Rev. Oct-01-2020