Free 51939.FH11 - Indiana

INTERPRETER / TRANSLATOR AGREEMENT TO ALLOW ON-SITE REVIEW OF ORGANIZATION
State Form 51939 (R2 / 1-08)

BUREAU OF MOTOR VEHICLES I00 North Senate Avenue Indianapolis, IN 46204 Telephone: (317) 232-6000

The Bureau of Motor Vehicles (BMV) shall prescribe, determine, and certify the qualifications of organizations that apply to provide interpreters / translators to serve non-English speaking customers who seek assistance with any BMV transactions.

The BMV shall have the right to authorize or conduct on-site reviews of the office facilities of organizations that provide interpreters / translators certified through the BMV interpreter / translator program.

I, __________________________________________________________________________________, as the authorized representative of
Name

_____________________________________________________________________________________, do hereby agree to allow the BMV
Name of organization

to authorize or conduct on-site inspections, at will, of the organizations office facilities.

Signature of organizations authorized representative

Date (month, day, year)

Address (number and street, city, state, and ZIP code)

Telephone number

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