County Court District Court ____________________________ County, Colorado Court Address: People of the State of Colorado v. COURT USE ONLY Defendant: Attorney or Party Without Attorney (Name and Address): Case Number: Phone Number: FAX Number: Division E-mail: Atty. Reg. #: Courtroom MOTION AND ORDER TO PAY LANGUAGE INTERPRETER __________________________________________________ Interpreter’s Name _____________________________ Language Interpreted __________________________________________________ Address _________________________ Phone (include area code) ___________________________________________________ City State Zip Code I request the Court for an order authorizing payment of the following fee(s) based upon the itemized hours and mileage listed: Name of Party Dates of Interpreting Mileage @ $.46 per Mile Court Time Waiting Time Hours of Travel Time Total Cost per Day $ Total Payment Requested: $____________________. I certify the above hours and mileage are correct. Agency verification of interpreter service is attached. __________________________________________________ Interpreter’s signature Date ORDER GRANTED DENIED _________________________________________________ Judge JDF 316 R1/08 MOTION AND ORDER TO PAY LANGUAGE INTERPRETER Magistrate Court Copy (white) Interpreter Copy (yellow) American LegalNet, Inc. www.FormsWorkflow.com