UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS PURCHASE ORDER/REQUEST FOR PAYMENT FOR INTERPRETING SERVICES PLEASE PRINT OR TYPE
V.
CASE NUMBER:
FROM: Name
Street
City
Zip
Social Security Number
Telephone Number
I hereby certify that I am Certified to interpret in the following Language TYPE OF PROCEEDINGS: Description: Location:
Prof. Qualified
Non-Certified and executed a contract with the Court on ________________
DATE:
Begin Time:
am/ pm
End Time:
am/pm
HALF DAY
FULL DAY
AMOUNT
Distance from residence to location must be more than 30 miles one way in order to claim any travel expenses. TRAVEL EXPENSES: # OF MILES TOLLS @ $ PER MILE AMOUNT AMOUNT
$0.00
$0.00
PARKING
OTHER EXPENSES: (Itemize and attach receipts)
AMOUNT
Courtroom Deputy/Pretrial/Probation verification that Information is correct and accurate:__________(initials)
DOCUMENT TRANSLATION: DATE: TOTAL # OF WORDS/PAGES RATE PER WORD AMOUNT OTHER EXPENSES: AMOUNT
$0.00
TOTAL AMOUNT OF INVOICE:
$0.00
Date:
Submitted by: (Interpreter's Signature)
Date approved __________________
Certifying Officer _____________________________ Title _______________________
________092000-DXXBBCX-D01MAXJ/M-2523 INTERPRETER RATES: Effective April 1, 2009 Certified and Professionally Skilled - Full Day $384 / Half Day - $208 Overtime $54 per hour of part thereof Language Skilled (Non-Certified) - Full Day - $185 / Half Day - $102 Overtime $32 per hour or part thereof ** Mileage - 55 cents as of 2/1/09
(InterpreterInvoice.wpd - 4/1/09 - previous editions obsolete)