Free DR627 request for interpreter.PDF - Ohio

DR 627 Eff. 7/96 Rev. 1/05

IN THE COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS BUTLER COUNTY, OHIO Judge Sharon L. Kennedy Judge Eva D. Kessler REQUEST FOR INTERPRETER

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Plaintiff/1st Petitioner

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Case Number

___________________________________ ___________________________________ vs./and ___________________________________
Defendant/2nd Petitioner

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Date

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Judge or Magistrate assigned for hearing

___________________________________ ___________________________________

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Name of party requiring interpreter

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Phone number of party or other contact person

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Name of attorney/party making request

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Phone number of attorney/party making request

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Hearing day, date, and time

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Type of hearing

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Type of interpretive service required

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Estimated amount of time interpreter needed

I hereby request interpretive services as described above. I understand that the court will arrange for an interpreter to be present as requested, and will inform me of the name and address of the interpretive service selected. I further understand that it is my responsibility to notify the interpretive service, in writing, if there is any change in the date or time of hearing, and that if I fail to do so, I will be held responsible for payment of the interpreter's fee for time spent at court for a hearing that was rescheduled without notice to the interpreter. ________________________________
Signature of attorney/party making request

CASE MANAGERS USE ONLY

Date Interpreter Agency Contacted: _______________________________________________ Name of Interpreter Agency:_____________________________________________________ Contact person: _______________________________________________________________ Interpreter Agency Address:_____________________________________________________ Street Number Street Name Suite Number _____________________________________________________ City State Zip ____________________________________________________ Phone Number Fax Number

Date the interpreter request form sent to administrative office: Court Officer who scheduled interpreter:

CERTIFICATE OF SERVICE I hereby certify that a copy of the within Entry was mailed on _________________________,20 , by U. S. regular mail to Plaintiff or , Attorney for Plaintiff, and Defendant or , Attorney for Defendant, at their respective residences or offices.

__________________________________________ Court Officer