Affirmation Of Services Guardian Ad Litem

BROOME COUNTY SURROGATE222S COURT IN THE MATTER OF AFFIRMATION OF SERVICES File No. STATE OF NEW YORK )COUNTY OF BROOME )ss.:, being duly sworn, deposes and says:1. That I am an attorney at law with offices at, and make this affirmation with respect to myappointment as Guardian ad Litem in the above captioned matter.2. That on , I was duly appointed by this Court as Guardian adLitem of .3. That in performance of my duties as Guardian ad Litem, I expended a total of hours as shown by the attached copy of my time records.4. That my usual hourly rate is $.5. That in performance of my duties, I expended $ in disbursements, to wit: Item Item Item Item6. I anticipate performing hours of additional legal service in completion of myduties as Guardian ad Litem.Wherefore, deponent respectfully requests that this Court fix a reasonable fee for servicesrendered, together with such other and further relief as the Court may deem just and appropriate.Dated Signature (Please Print Name Under SignatureESTATE VALUE FEE AS SET BY SURROGATE American LegalNet, Inc. www.FormsWorkFlow.com