Form Cc-Dc-041 - Request For Spoken Language Interpreter
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1CIRCUIT COURT
DISTRICT COURT OF MARYLAND FOR
City/County
Located at
Case No.
Court Address
STATE OF MARYLAND
or
vs.
Plaintiff/Petitioner
Defendant/Respondent
REQUEST FOR SPOKEN LANGUAGE INTERPRETER
Requests for interpreter should be submitted to the court not less than thirty (30) days before the proceeding for which
the interpreter is requested.
Criminal
Civil
Traffic
Juvenile
Family
Other:
Type of court proceeding:
If this request is for Juvenile, please check the appropriate box:
Delinquent
Child in Need of Assistance
(CINA)
Child in Need of Supervision
Termination of Parental Rights
Adoption
Other:
(CINS)
(TPR)
1. Hearing/trial date:
Time:
Courtroom:
An interpreter is needed for THIS HEARING OR EVENT ONLY.
I am a party (Plaintiff or Defendant) and need an interpreter FOR ALL HEARINGS & EVENTS RELATED TO
THIS CASE, unless indicated otherwise.
2. Location of hearing/trial:
3. LANGUAGE:
4. DIALECT:
5. Country & region where language is spoken
:
(do not omit)
Name of Person Requesting Interpreter:
Name of Person Who Needs Interpreter:
Person Needing Interpreter is the:
Defendant/Respondent
Attorney
Plaintiff/Petitioner
Victim
Victim's Representative (includes a family member or guardian of a victim who is a minor, deceased, or disabled)
Witness for:
the Defendant/Respondent
the State
the Plaintiff/Petitioner
Other:
NOTICE: If a court hearing or proceeding is postponed or continued, you do not need to make a new interpreter
request. An interpreter will be provided for the new hearing date.
Date
Signature of Applicant/Applicant's Attorney or Representative
Printed Name
Telephone Number
Address
Fax
City, State, Zip
E-mail
CERTIFICATE OF SERVICE
I certify that I served a copy of this Motion / request upon the following party or parties by:
mailing first class mail, postage prepaid
hand delivery, on
to:
Date
Name
Address
Name
Address
Date
Signature of Party Serving
CC-DC-041 (Rev. 07/2015)
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