Tillamook County Circuit Court Request for Interpreter Applicant Name: Person submitting request (name if different from applicant): Applicant Address:: Contact Phone Number: 1. Name of proceeding(s) to be covered: 2. Date(s) of proceeding(s): 3. Case Number (if applicable): 4. Applicant is: G Party 5. Language spoken: G Witness G Juror G Attorney G Other (specify) ___________ Date: _____________________ ...................................................................... (Type or print name) ____________________________________ (Signature of applicant) As soon as possible, or at least four judicial days prior to the proceeding, submit this form to: Trial Court Administration, Tillamook County Circuit Court, 201 Laurel Ave, Tillamook, OR 97141 The Court's coordinator of interpreter services may be reached at (503)842-2596 ext 2110. Fax (503) 842-2597 Revised: 6/8/05 American LegalNet, Inc. www.USCourtForms.com