Attorney or Party without Attorney (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FAX NO: SUPERIOR COURT OF CALIFORNIA, COUNTY OF TEHAMA Case name: REQUEST FOR INTERPRETER AT COURT HEARING CASE NUMBER: PLEASE PRESENT THIS REQUEST FORM AT YOUR EARLIEST CONVENIENCE. PLEASE IDENTIFY THE LANGUAGE AND SPECIFIC DIALECT: Spanish Laotian Mandarin Other INTERPRETER NEEDED FOR HEARING ON: Date: Type of Hearing time: Department Time estimate of Hearing Cantonese Punjabi Thai IF RELATED CASES ARE INVOLVED, DO THE PARTIES STIPULATE TO THE USE OF ONE INTERPRETER Yes No IF NO, HOW MANY INTERPRETERS ARE NEEDED PLEASE IDENTIFY WHO THE INTERPRETER IS NEEDED FOR INCLUDING PARTIES, WITNESSES, OR OTHER PERSONS WITH A SIGNIFICANT INTEREST. Name of Person needing Interpreter Plaintiff Dated: Defendant Petitioner Respondent Witness Other Type or print your name AD005 ­ Interpreter Request Form (03/15) Sign your name American LegalNet, Inc. www.FormsWorkFlow.com