Temporary Judge Fee Statement {RI-MC008}

SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE TEMPORARY JUDGE FEE STATEMENT VENDOR INFORMATION: Name: Address: Identification Number: Phone Number: City/State/Zip: For services as a temporary judge at (BRANCH//DIVISION/DEPARTMENT) DATE TIME HOURS (SIGNATURE OF TEMPORARY JUDGE) (DATE) COURT USE ONLY I certify that this fee application has been submitted in compliance with court policy and the court executive office is hereby ordered to issue payment in the amount of $ payable to the above named person for services rendered. Amount authorized $ Authorized by: Date: Approved: (SUPERVISING JUDGE) (DATE) Printed Name: Phone Number: So ordered: (PRESIDING JUDGE) (DATE) COURT CODING Fund: 110001 Cost Center: 335911 PECT: 1100 GL: 939105 Approver's Initials: Approver's Printed Name: COMMENTS: Date: Page 1 of 1 Approved for Optional Use Riverside Superior Court RI-MC008 [Rev. 03/11/15] TEMPORARY JUDGE FEE STATEMENT riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com