Select A County: Winnebago Boone

Case Number:

Courtroom Number:

Are you aware of any associated court cases in this County?    Yes   No

If so, please provide the Case Number or any other details:

Name of Person needing an interpreter (LEP):

*Please complete a form for each person requiring an interpreter*

	The person who needs an interpreter is: (choose one)
	A party who will need an interpreter for all court dates. Next Court Date & Time:
	A person who brings or defends a case on behalf of a minor or adult disabled party for all court dates. Next Court Date & Time:
	A parent/legal guardian of a minor party or minor victim who will need an interpreter for all court dates. Next Court Date & Time:
	A parent/legal guardian of a disabled adult party who will need an interpreter for all court dates. Next Court Date & Time:
	A witness who is testifying on Court Date & Time:
	A juror (sign language only) in court on Court Date & Time:
	A spectator (sign language only) in court on Court Date & Time:

Notification completed by:

Relation to LEP: Self Family/Friend Attorney onCase Jail ADR Center Probation Jury Commission Court Appointed Mediator Court Staff Other

Phone Number:

Email (Optional):

Language Needed:

Approximate Duration of Next Court Proceeding:

Notes (Optional):

By submitting this request, you are certifying that everything is true and correct.