Form Fw-A 5 En Csd - Request For Court Interpreter By An Individual Who Has Been Given Fee Waiver

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REQUEST FOR COURT INTERPRETER
BY AN INDIVIDUAL WHO HAS BEEN GIVEN FEE WAIVER
(PLEASE PRINT CLEARLY)
This form should be used by individuals who have been given a Fee Waiver Certificate to request the services of a court-
provided interpreter for themselves or for one or more of their witnesses, in a language other than English or French.
Court File/Claim Number:
Contact the court office immediately if your
contact information changes.
Full Legal Name:
To be completed by court office staff:
Current Mailing Address:
Court Office Address:
Telephone No.:
Court Office Telephone No.:
(any daytime numbers where you may be contacted)
Fax:
E-mail Address:
Court interpreters in civil, family and Small Claims Court cases will be provided to individuals who have been given a Fee
Waiver Certificate and who indicate the need for an interpreter for either themselves or for their witness(es), for all court
appearances at which a judicial official presides. The presence and use of the court interpreter in the courtroom remains
at the discretion of the presiding judicial official.
SECTION A
If you have been given a Fee Waiver Certificate and you require a court interpreter for yourself:
1. Indicate the language you require:
(language required)
2. Sign and date this form at the bottom.
3. Provide the signed form to court staff immediately.
This form will be used to schedule an interpreter for you for every event in your case.
SECTION B
If you have been given a Fee Waiver Certificate and one or more of your witnesses requires a court interpreter, you must
complete a new copy of this form for each court appearance where the witness will be appearing and will require an interpreter:
1. Fill out the information below indicating the language required and date and time of the court appearance.
2. Sign and date this form at the bottom.
3. Provide the signed form to court staff as soon as the information is available and at least seven (7) working days
before the date of the court appearance. Working days are defined as days when the court office is open.
(name of witness)
(language required)
(date and time required)
(name of witness)
(language required)
(date and time required)
(name of witness)
(language required)
(date and time required)
Check here
if you have additional witness(es). List them on a separate sheet, indicating the language and date and
time required and attach it to this form.
NOTE: After you have submitted this request for an interpreter, if you become aware that an interpreter is not required for
a court appearance, notify the court office immediately to cancel the interpreter.
Date of signature
Signature of Requestor
FOR COURT OFFICE STAFF USE ONLY
Forwarded to
on
(name of person or office)
(date forwarded)
FW-A 5 EN CSD (09/05)

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