Free REQUEST FOR INTERPRETER SERVICE (SCA-M1030) - West Virginia

IN THE MAGISTRATE COURT OF

COUNTY, WEST VIRGINIA

Plaintiff v. Case No.

Defendant

REQUEST FOR INTERPRETER SERVICE

As a

party

witness

juror

other (explain how you will be participating

in the court proceeding) in the above-styled case, which is scheduled to take place (date and time) I,
(name of requester)

, hereby request the appointment of a qualified in preparation with counsel and/or a sign interpreter OR during in-court proceedings.

interpreter to assist me My need is for:

an oral interpreter (one who interprets language

through facial and lip movements) OR language and the
(name of foreign language)

an interpreter who understands and speaks both the English language or
(please describe type of interpreter needed)

other

interpreter. I hereby certify that not fluent in the English language. I am deaf or have a serious hearing impairment OR that I am

Signature of Requester

Americans with Disabilities Act, Title II; W.Va. Code §§ 5-14A-1 et seq., 57-5-7 SCA-M1030NP / 7-99