Free Interpreter Worksheet - Maryland

CLEAR FORM

CJA Voucher Interpreter Attachment
Name:_____________________________________________ Language/Rate:______________________________________ Date(s) of Service:____________________________________ TIME Duration of Meeting:

Start Time_________ End Time_________ (excluding any breaks) = ________hour(s)/tenths of hours Travel Time: Departure Time_______from Location_____________ Arrival Time_________ at Location_______________ = ________hour(s)/tenths of hours Departure Time_______from Location_____________ Arrival Time_________ at Location_______________ = ________hour(s)/tenths of hours Travel Time prorated for services provided to another client? Yes/No If Yes, name client(s):_____________________________________________ A. TOTAL TIME =________hour(s)/tenths of hours EXPENSES Total Number of Miles_____ @ _____cent per mile = $________ **Parking:$_______ **Metro: $_______ Mileage prorated for services provided to another client? Yes/No If Yes, name client(s):_____________________________________________ B. TOTAL TRAVEL EXPENSES = $________ **Other Expense(s):description:_________________________ $________ C. TOTAL OTHER EXPENSES = $________

GRAND TOTAL OF TIME AND EXPENSES = $____________

**Required receipt(s) attached here: