Interpreter Request Form

The Judiciary has a responsibility to ensure those with limited English proficiency (LEP) and those who are deaf or hard of hearing are not at a disadvantage to fully exercise their right to due process under the law.

Instructions: Date Format must be mm/dd/yyyy or the form will not submit.

Name of person requiring Interpreter

Date of Request

Date Format mm/dd/yyyy

Type of Court Event

Magisterial District Court

Civil

Criminal

Juvenile

Petitioner/Plaintiff Name (Complete for Civil Only)

Defendant/Respondent Name

Case Number

Hearing Start Date

Date Format mm/dd/yyyy

Hearing Start Time

Hearing Location (List Courtroom # if known)

Type of Hearing

Relationship to Case (Select "Yes" for one)

Defendant / Respondent

Witness

Other

Petitioner/Plaintiff

Juvenile

Details

Victim

Parent/Person in loco parentis

Language: Provide details if necessary:

Enter details if needed

Spoken Language

Country of Origin:

Deaf/Hard of Hearing: American Sign Language

Other ASL Type

Requestor's Name

U.S. Phone Number

Requestor's Email

Enter a valid email address

Description

Please give a brief description of any educational, physical, mental or other particular condition which may affect or limit the communication of the person for whom the interpreter is requested:

Brief Description

Rules of Conduct

In accordance with Act 172 of 2006 [42 Pa.C.S. §§ 4411(e) and 4431(e)], the Court Administrator of Pennsylvania has established Rules of Professional Conduct for Judiciary Interpreters in the Unified Judicial System of Pennsylvania. To learn more about these Rules, please visit the Interpreter Rules of Conduct page established by the Unified Judicial System.:

reCAPTCHA