ADMINISTRATIVE OFFICE OF THE TRIAL COURT
AUTHORIZED SIGNATORY LIST FOR INTERPRETER SERVICES

COURT NAME: ___________________________________________________________ ADDRESS:______________________________________________________________

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MMARS ORGANIZATION NUMBER:

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Please type or print the name and title of the three (3) persons authorized to complete and transmit the Request for interpreter form as well as verify and sign the Interpreter Daily Service Record. 1. Name: Signature: 2. Name: Signature: 3. Name: Signature: Title: Court/Office Location: Title: Court/Office Location: Title: Court/Office Location:

APPROVAL SIGNATURE

AUTHORIZED SIGNATORY:

Please return copies of this form to: Administrative office of the Trial Court Attn: Office of Court Interpreter Services Two Center Plaza - Ninth Floor Boston, MA 02108 June/2000 AND Massachusetts Commission for the Deaf and Hard of Hearing Attn: Court Interpreter Referral Specialist 210 South Street Boston, MA 02111