Court Interpreter Authorization Voucher Form

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COURT INTERPRETER
PAID BY
AUTHORIZATION VOUCHER
MATTHEW J. DYKMAN, CLERK
U.S. DISTRICT COURT 4651
Interpreter ____________________________________________________
Social Security/Tax Number ______________________________________
Mailing Address________________________________________________
City/State/Zip__________________________________________________
is hereby authorized to perform the following interpreting assignment in:
Q
Q
Q
Spanish
Navajo
Other (specify) ____________________, for ___________ day(s)
on ________________________________. Check will be made out to above mentioned interpreter unless indicated
as follows ______________________________________________________________________________.
Hour
Defendant and/or
Date
Judge
Witness – Number
Case No.
Proceeding
From
To
Fee: $____________________ x ____________________ day(s)/half day
$ _________________________
Overtime: ____________ hours at ____________________/hour
$__________________________
Travel (when applicable)* ___________ miles @ _________¢ / mile
$ _________________________
Travel Time:
Home to Court _______________
Tolls
$__________________________
Court to Home _______________
Parking
$__________________________
Rates:
CERTIFIED – full day $384 / half day $208
TOTAL $_________________________
NON-CERTIFIED – full day $185 / half day $102
TRAVEL – 55¢ per mile
I hereby certify under penalty or perjury that the foregoing is true and correct.
Date: ________________________
Signature: ______________________________________________
Interpreter
*Mileage may be claimed for travel 30 miles or more, one way; rates are as of 1/1/06.
Pursuant to authority vested in me, I certify that the voucher is correct and proper for payment.
______________________
________________________________________________
__________________________________
(Date)
(Approved for Payment)
(Title)
ACCOUNTING CLASSIFICATION
_______ - 092000 - DXXBBCX - D10NMX_______ - 2523

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