COMMONWEALTH OF MASSACHUSETTS
________________,SS: HOUSING COURT DEPARTMENT _______________ DIVISION CASE NO. ________________ _________________________ PLAINTIFF(S) VS. ________________________ DEFENDANT(S)
REQUEST FOR INTERPRETER
Plaintiff/Defendant hereby requests an interpreter in the _____________________________ language for the trial/hearing in this action, which has been scheduled for __________________ at ____________________. To be paid by: Plaintiff [ ] Defendant [ ] Waiver of Fees[ ]
Date: ________________
Signed: ___________________________ Street: ___________________________ City: _____________________________
Court Action: ___________________________, has been appointed as interpreter in the above case, to be heard _______________ at _______________. Confirmed by: ____________________ Copies to both parties [ ] Date: ___________________