Request For Hearing On Order For Reimbursement Of Court Appointed Attorney Fees {F-104}

ATTORNEY OR PARTY WITHOUT ATTORNEY TELEPHONE NO. FOR COURT USE ONLY ATTORNEY FOR (NAME) SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER/PLAINTIFF: CASE NUMBER RESPONDENT/DEFENDANT: REQUEST FOR HEARING ON ORDER FOR REIMBURSEMENT OF COURT APPOINTED ATTORNEY FEES Party's Name: _______________________________________ Brief Explanation for Request: _________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ A confidential hearing on this request will be held as follows: a. Date: Time: b. Address (if different than above): · Dept. I understand and acknowledge that an updated Income and Expense Declaration (form FL-150), along with any supporting financial information MUST BE filed at least 5 days prior to the hearing date listed above. If the Court has not received an updated Income and Expense Declaration (form FL-150) at least 5 days prior to the hearing date, the Court may use its discretion to take the matter off calendar. The hearing date listed above will be a confidential hearing. A copy of this request does not need to be served on any other party. · · ____________________________________________ Signature of Attorney / Party in Pro Per Request for Hearing ______________________ Date American LegalNet, Inc. www.FormsWorkFlow.com Local Form F-104 Mandatory Use Form New 02/05/2016