SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER Form Adopted for Mandatory Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 1 of 2 Form No. PL-CW005 Effective 01-01-2016 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number, and Address): TELEPHONE NO.: FAX NO.: EMAIL ADDRESS: SUPERIOR COURT OF CALIFORNIA, COUNTY OF PLACER 10820 Justice Center Drive 2501 N. Lake Blvd. P.O. Box 619072 P.O. Box 5669 Roseville, CA 95661-9072 Tahoe City, CA 96145 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: FOR COURT USE ONLY REQUEST FOR INTERPRETER (CIVIL & FAMILY LAW) CASE NUMBER: 1. My name is: 2. I have a hearing as follows: Date: Time: Department: 3. I understand I should submit this form for every court hearing in which I need an interpreter. 4. I need an interpreter at the hearing to interpret the following language: Spanish (Espa361ol) Russian (P) Romanian (Rom342nete) Punjabi ( ) Korean () Lao () Tagalog Other: 5. I understand a court interpreter will only provide verbal interpretation of spoken language and documents and that they will not provide written translation. 6. The interpreter is for a party to the case a witness* (*Fees payable to the court may apply.) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature of Declarant The Area Below is For Court Use Only CH227Civil harassment with violence, threats of violence, or stalking [1] CI227Civil harassment [6/FW] CO227All other civil cases [8/FW] DV227Domestic violence alone [1] EA227Elder/dependent adult abuse with physical abuse or neglect [1] EF227All other elder/dependent adult abuse [6/FW] FC227Child support [7/FW] FD227Domestic violence in existing FL case [1] FO227All other family law [7/FW] FT227Termination of parental rights [3/FW] FV227Custody and visitation [5/FW] PG227Conservatorship & guardianship [4/FW] PO227All other probate [8/FW] UD227Unlawful detainer [2] Other: No code Fee waiver on file Sent to Court Interpreter Coordinator on American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER Form Adopted for Mandatory Use www.placer.courts.ca.gov Superior Court of California, County of Placer Page 2 of 2 Form No. PL-CW005 Effective 01-01-2016 Instructions Court proceedings are conducted in English. If a party or a witness does not speak English well, he or she may need an interpreter to testify, to speak to the judge, and to understand what others are saying in the proceeding. Certified and registered court interpreters are specifically trained to interpret in court proceedings. If you need language assistance in one of the case types listed below, you should ask the Court if it can provide a court interpreter by filling out this form. The Court222s first priority is to try to provide interpreters in the following kinds of cases: 1. Domestic violence cases and family law cases in which there is a domestic violence issue; Elder or dependent adult abuse cases involving physical abuse or neglect; and civil harassment cases involving temporary restraining orders 2. Unlawful detainer or eviction cases The Court may also be able to provide interpreters in some languages in some other civil cases. Where possible, the Court will try to provide interpreters in the following order*: 3. Termination of parental rights proceedings 4. Actions relating to conservatorships or guardianships 5. Actions for child custody or visitation 6. Elder or dependent adult abuse cases not involving physical abuse 7. All other family law actions 8. All other civil actions. *In these types of cases, preference will be given to parties with financial need who have qualified for a fee waiver, so if you need a court interpreter and need financial assistance, you should apply for a fee waiver if you do not already have one. To do so, complete and file a Request to Waive Court Fees (Civil Actions) (form FW-001). The priorities listed above have been set by the Legislature to outline how courts may be reimbursed for providing interpreters in civil cases. Although the Court will attempt to provide interpreters in those case types in that order, courts are not required to provide interpreters in those case types and may not always be able to due to cost and availability constraints. If you have submitted this form and the Court cannot provide an interpreter for your hearing, you will be notified in advance of your hearing. However, you are not entitled to a continuance unless the Judicial Officer deems it appropriate. You may submit this form at the clerk222s office or window in any court location where the case type at issue is heard, at Jury Services on the second floor of the Santucci Justice Center in Roseville, or you may mail the form to P.O. Box 619072, Roseville, CA 95661, ATTN: Interpreter Coordinator. Please ensure the court receives the form at least five (5) court days in advance of the hearing. Please submit this form for each and every court hearing in which you need an Interpreter, as the Court may be able to provide an interpreter for some hearings and not for others. The Court will notify you if it cannot provide an interpreter at least two (2) court days in advance of your hearing. American LegalNet, Inc. www.FormsWorkFlow.com