Free INT-110 2009-07-01.ofm - California

INT-110 QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED INTERPRETER Provisional Qualification by Order of Presiding Judge
INTERPRETER NAME: LANGUAGE: Original filing in this court Within Beyond Renewal No.: Number of six-month periods this interpreter has been used: the period allowed by Cal. Rules of Courts, rule 2.893
FOR COURT USE ONLY (FILE WITH THE COURT ADMINISTRATOR)

INSERT NAME OF COURT, JUDICIAL DISTRICT, AND BRANCH COURT, IF ANY

The following questions may be addressed to the noncertified or nonregistered interpreter as voir dire, or the court may have the prospective interpreter answer the questions in writing on this form. All of the information provided by the noncertified or nonregistered interpreter should be considered by the court to determine whether the interpreter is appointed to interpret the stated language. Interpreter's Name: Address: Phone (home): Phone (work): Driver's License.: -OR- State I.D.:

Language: Designated language: Noncertified interpreter Nondesignated language: Nonregistered interpreter

State: State:

1. Previous provisional qualification periods (since January 1996) a. Since January 1, 1996, have you been provisionally qualified by a presiding judge in this court or any other court under California Rules of Court, rule 2.893? No Yes. For each period state (see p. 4): Beginning date: Court: Beginning date: Court: Court: Beginning date: Court: Beginning date: b. Since January 1, 1996, have you interpreted in any court without being provisionally qualified? No Yes (explain, giving court names and dates): 2. Interpreter examinations and evaluations a. Have you taken the State of California Court Interpreter Certification Examination or the Judicial Council English Fluency Examination in the language to be interpreted? Yes (dates): No What were the results?

b. Have you taken the State of California Administrative Hearing Interpreter Examination? Yes (dates): What were the results? If passed, what is your I.D. No.? Not given in the language specified above No (check one): Not taken c. Have you taken the Federal Court Interpreter Certification Examination? What were the results? Yes (dates): If passed, what is your I.D. No.? (If applicable): Not given in the language specified above No (check one): Not taken d. Have you taken a Court Interpreter Certification Examination from other states? Yes (dates): Give states and results of each: If passed, what is your I.D. No. (if applicable)? No (check one): Not taken Not given in the language specified above
Page 1 of 4 Form Adopted for Mandatory Use Judicial Council of California INT-110 [Rev. July 1, 2009]

QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED INTERPRETER sections (Provisional Qualification by Order of Presiding Judge)

Gov. Code, 68561(c), 68564(d) www.courtinfo.ca.gov

American LegalNet, Inc. www.FormsWorkflow.com

INT-110
INTERPRETER (name): COURT NAME:

2. Interpreter examinations and evaluations e. Have your interpreting skills been evaluated? Yes No If yes, which aspects of your skills were evaluated? (check all that apply): Written Oral Consecutive Simultaneous Sight translation Oral and written Other (specify): What languages? When were you evaluated? What were the results? Which authority evaluated your skills? 3. General education Highest level degree attained: High school Jr. college Name of institution: Degree awarded: Degree awarded: 4. Language training a. How did you learn English? b. How did you learn the language to be interpreted? c. In which languages were you educated? Elementary Jr. High Language (specify): High school (1) (2) spoken at home (specify): d. What languages are were 5. Interpreting and translation training Institutions attended: 6. Teaching experience Do you have any language teaching experience? If yes, which languages? At what levels? University Year: Year:

University

Graduate degree Major: Major:

Postgraduate

Year: Year: Yes No

7. Interpreting experience a. Have you interpreted in any court proceedings? Yes No When? Where? What languages? Approx. No. of total days: Type of hearing (check all that apply): Arraignment Trial Deposition Civil Which modes of interpreting did you employ? (check all that apply): Consecutive Simultaneous Sight translation b. Have you ever interpreted in an administrative hearing? Yes When? Where? Types of hearings (specify): What languages? Approx. No. of total days: Which modes of interpreting did you employ? (check all that apply): Simultaneous Sight translation Consecutive No

Give dates: Criminal Juvenile

Give dates:

INT-110 [Rev. July 1, 2009]

QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED INTERPRETER (Provisional Qualification by Order of Presiding Judge)

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INT-110
INTERPRETER (name): COURT NAME:

7. Interpreting experience Yes No c. Have you interpreted in any noncourt setting? Where? When? Types of assignments? Approx. No. of total days: Give dates: What languages? Which modes of interpreting did you employ? (check all that apply): Sight translation Consecutive Simultaneous d. Have you ever been disqualified from interpreting in any court or administrative hearing? Yes If yes, please explain:

No

What languages? 8. Translation Do you have any experience in written translation? If yes please explain:

Yes

No

What languages? 9. Code of professional conduct a. Have you had any training in professional ethics for court interpreters? Please explain:

Approx No. of pages:

Yes

No

b. Have you taken the Judicial Council sponsored court interpreter ethics workshop? No Yes c. Do you have a copy of the Standards of Professional Conduct for Court Interpreters? d. Have you read and do you understand the Standards of Professional Conduct for Court Interpreters?

Yes (date): No Yes

No

10. Training in legal terminology What training have you received in California legal terminology as required by Government Code section 68564?

11. Orientation to court interpreting a. Have you received training in criminal procedure? Yes No If yes, from whom? When? Yes No b. Have you received training in civil procedure? If yes, from whom? When? c. Have you taken the Judicial Council's court interpreter orientation workshop?

No

Yes (date):

12. Criminal offenses Have you ever been convicted of violating any federal law, state law, county or municipal law, regulation, or ordinance? (Do not include traffic infractions.) Yes No If yes, please explain: INTERPRETER'S DECLARATION (All interpreters must sign)
I declare under penalty of perjury under the laws of the State of California that the information provided above and on the preceding pages is true and correct. I understand that any false or misleading statements disqualify me from being considered for interpreting assignments in the trial courts, in addition to other penalties provided by law. Date:

(TYPE OR PRINT NAME) INT-110 [Rev. July 1, 2009]

(SIGNATURE OF PROSPECTIVE INTERPRETER)

QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED INTERPRETER (Provisional Qualification by Order of Presiding Judge)

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INT-110
INTERPRETER (name): COURT NAME:

INTERPRETER'S DECLARATION
(Check all that apply) 1. 2. I have never been provisionally qualified or appointed to interpret in the trial courts under California Rules of Court, rule 2.893. Noncertified interpreters I have been provisionally qualified or appointed to interpret in the trial courts under California Rules of Court, rule 2.893, AND a. I have not exceeded any of the provisional qualification periods stated below (see Cal. Rules of Court, rule 2.893): (1) Two 6-month periods for noncertified Spanish interpreters in counties with a population greater than 80,000 (2) Four 6-month periods for noncertified Spanish interpreters in counties with a population less than 80,000 (3) Four 6-month periods for noncertified interpreters of designated languages other than Spanish I have exceeded the provisional qualification periods specified in California Rules of Court, rule 2.893.

b. 3.

Nonregistered interpreters I have been provisionally qualified or appointed to interpret in the trial courts under California Rules of Court, rule 2.893, AND a. I have not exceeded any of the provisional qualification periods stated below (see Cal. Rules of Court, rule 2.893): (1) Four 6-month periods for nonregistered interpreters. I have exceeded the provisional qualification periods specified in California Rules of Court, rule 2.893.

b.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I understand that any false or misleading statements disqualify me from being considered for interpreting assignments in the trial courts, in addition to other penalties provided by law. Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF PROSPECTIVE INTERPRETER)

FINDING OF PROVISIONAL QUALIFICATION and ORDER OF THE PRESIDING JUDGE
(Gov. Code, sections 68561(c), 68564(d), 71802 (b)(1) and (d)) 1. Interpreter (name): Case Number:

Date of Proceeding: 2. Language: 3. Finding: For six months from the date of this order, the above-named interpreter is found to be provisionally qualified to be considered for appointment to interpret the language specified in any proceeding in this court, and a. b. has not exceeded the provisional qualification periods specified in California Rules of Court, rule 2.893. has exceeded the provisional qualification periods specified in California Rules of Court, rule 2.893, but good cause exists under rule 2.893 to continue appointing the interpreter.

4. THE COURT ORDERS that the above-named interpreter may be considered for appointment by any judge of this court to interpret the specified language in any proceeding for which the judge in the proceeding finds the interpreter to be qualified. This order expires six months from the date of signature. Date:

........................................................................................
(TYPE OR PRINT NAME) PRESIDING JUDGE DESIGNATED JUDICIAL OFFICER

INT-110 [Rev. July 1, 2009]

QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED INTERPRETER (Provisional Qualification by Order of Presiding Judge)

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