Declaration And Certification Form Of Certified Court Interpreter - State Of California
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1DECLARATION AND CERTIFICATION OF
CERTIFIED/REGISTERED COURT INTERPRETER
I, _______________________, declare that I am a certified/registered court interpreter/translator. I am
certified/registered to interpret and translate from the ________________________ language to the
_______________________ language, by the State of California, Certification/Registration
Number(s) __________________.
I further declare that I have translated the attached document from the ____________________ language to the
ENGLISH language. I declare to the best of my abilities and belief, that this is a true and correct translation of
the __________________________________ language text of ______________________________________.
(Insert title of document)
Specific Description of the Document
_____________________________________________________________________
_____________________________________________________________________
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
This declaration sign this _______ day of _______________________ , 20____ , in
__________________________ , California.
__________________________________________________
Print Name of Certified/Registered Court Interpreter
__________________________________________________
Signature of Certified/Registered Court Interpreter
Certificate of Acknowledgment
A notary public or other officer completing this certificate
verifies only the identity of the individual who signed the
document to which this certificate is attached, and not
the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
}
COUNTY OF _______________________}
On ______________ before me, _____________________________________________________, personally appeared
(Date)
(Print Name and Title of Official)
_______________________________________________________________________________________,
(
)
Insert name of person being acknowledged
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that
by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and
correct.
WITNESS
.
my hand and official seal
(Seal)
________________________________________
Signature
(Officer signature)
ACR 320 (Rev. 12/2014)
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