Form INT-110 Qualifications of a Noncertified or Nonregistered Spoken Language Interpreter - California

Form INT-110 is a California Courts form also known as the "Qualifications Of A Noncertified Or Nonregistered Spoken Language Interpreter". The latest edition of the form was released in January 1, 2018 and is available for digital filing.

Download a PDF version of the Form INT-110 down below or find it on California Courts Forms website.

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INT-110
FOR COURT USE ONLY
INTERPRETER NAME:
(FILE WITH THE COURT ADMINISTRATOR)
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
WORK NO. :
E-MAIL ADDRESS:
DRIVER'S LICENSE or STATE ID:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED SPOKEN LANGUAGE INTERPRETER
This form is used to appoint a PROVISIONALLY QUALIFIED interpreter for a 6-month period under rule 2.893(d)(4), in one language.
If you are using a temporary interpreter in a single brief appearance only, use form INT-140.
LANGUAGE (list only one)
1st
2nd
3rd
4th
5+
Mark which 6-month period applies to this interpreter:
Within the period allowed by Cal. Rules of Court, rule 2.893
Beyond the period allowed by Cal. Rules of Court, rule 2.893
Please mark all that apply:
Language with no certified or registered status available, either
Designated language: noncertified interpreter
not working from English to another language (relay interpreter)
Nondesignated language: nonregistered interpreter
or no certified exam available in the language pairing
Provisionally qualifying for a 6-month period
The following questions may be addressed to the noncertified or nonregistered interpreter as voir dire, or the court may have the
prospective interpreter answer the questions in writing on this form. All of the information provided by the interpreter should be
considered by the court to determine whether the interpreter is appointed to interpret the stated language.
1. Previous provisional qualification periods (since January 1996)
a.
Since January 1, 1996, have you been provisionally qualified by a presiding judge in this court or any other court under Cal.
Rules of Court, rule 2.893? (A period may not exceed 6-months. See also p. 5):
No
Yes. For each period state:
Beginning date:
Court:
Beginning date:
Court:
Beginning date:
Court:
Beginning date:
Court:
See attachment (for additional information)
b.
Since January 1, 1996, have you interpreted in any court without being provisionally qualified?
(explain, giving court names and dates):
No
Yes
2.
Interpreter and translator credentials
Please list the two most relevant interpreter or translator credentials you currently hold, and which are in good standing (e.g., court
interpreter certification from another state, in another language, or for the federal courts; ATA certification; community college
certificate; etc.):
Credential name:
ID #:
Language pair:
Date of initial credential:
Credential name:
ID #:
Language pair:
Date of initial credential:
Page 1 of 6
Form Adopted for Mandatory Use
Government Code, §§ 68561(c), 68564(d);
QUALIFICATIONS OF A NONCERTIFIED OR
Judicial Council of California
Cal. Rules of Court, rule 2.893
NONREGISTERED SPOKEN LANGUAGE INTERPRETER
INT-110 [Rev. January 1, 2018]
www.courts.ca.gov
INT-110
FOR COURT USE ONLY
INTERPRETER NAME:
(FILE WITH THE COURT ADMINISTRATOR)
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
WORK NO. :
E-MAIL ADDRESS:
DRIVER'S LICENSE or STATE ID:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
QUALIFICATIONS OF A NONCERTIFIED OR NONREGISTERED SPOKEN LANGUAGE INTERPRETER
This form is used to appoint a PROVISIONALLY QUALIFIED interpreter for a 6-month period under rule 2.893(d)(4), in one language.
If you are using a temporary interpreter in a single brief appearance only, use form INT-140.
LANGUAGE (list only one)
1st
2nd
3rd
4th
5+
Mark which 6-month period applies to this interpreter:
Within the period allowed by Cal. Rules of Court, rule 2.893
Beyond the period allowed by Cal. Rules of Court, rule 2.893
Please mark all that apply:
Language with no certified or registered status available, either
Designated language: noncertified interpreter
not working from English to another language (relay interpreter)
Nondesignated language: nonregistered interpreter
or no certified exam available in the language pairing
Provisionally qualifying for a 6-month period
The following questions may be addressed to the noncertified or nonregistered interpreter as voir dire, or the court may have the
prospective interpreter answer the questions in writing on this form. All of the information provided by the interpreter should be
considered by the court to determine whether the interpreter is appointed to interpret the stated language.
1. Previous provisional qualification periods (since January 1996)
a.
Since January 1, 1996, have you been provisionally qualified by a presiding judge in this court or any other court under Cal.
Rules of Court, rule 2.893? (A period may not exceed 6-months. See also p. 5):
No
Yes. For each period state:
Beginning date:
Court:
Beginning date:
Court:
Beginning date:
Court:
Beginning date:
Court:
See attachment (for additional information)
b.
Since January 1, 1996, have you interpreted in any court without being provisionally qualified?
(explain, giving court names and dates):
No
Yes
2.
Interpreter and translator credentials
Please list the two most relevant interpreter or translator credentials you currently hold, and which are in good standing (e.g., court
interpreter certification from another state, in another language, or for the federal courts; ATA certification; community college
certificate; etc.):
Credential name:
ID #:
Language pair:
Date of initial credential:
Credential name:
ID #:
Language pair:
Date of initial credential:
Page 1 of 6
Form Adopted for Mandatory Use
Government Code, §§ 68561(c), 68564(d);
QUALIFICATIONS OF A NONCERTIFIED OR
Judicial Council of California
Cal. Rules of Court, rule 2.893
NONREGISTERED SPOKEN LANGUAGE INTERPRETER
INT-110 [Rev. January 1, 2018]
www.courts.ca.gov
INT-110
INTERPRETER (name):
3.
Interpreter examinations and evaluations (related to credentials you do not currently hold)
a.
Have you taken the State of California Written Exam, Bilingual Interpreting Exam (BIE), or the Oral Proficiency Exam in
English (OPE) and/or in the other language to be interpreted? Certain examination requirements apply after the first 6-month
period of provisional qualification (See page 5). (list all exams, date taken, and results):
None taken
Yes (fill in below):
Exam/language:
(date):
What were the results?
Exam/language:
(date):
What were the results?
Exam/language:
(date):
What were the results?
Exam/language:
(date):
What were the results?
See attachment (for additional information)
b.
Have you taken the Federal Court Interpreter Certification Examination?
Yes (dates):
What were the results?
No
(check one):
Not taken
Not given in the language specified above
c.
Have you taken a Court Interpreter Certification Examination from other states?
Yes (dates):
Give states and results of each:
No
(check one):
Not taken
Not given in the language specified above
d.
Have your interpreting skills been evaluated in any other way?
Yes
No
If yes, which aspects of your skills were evaluated? (check all that apply):
Interpreting modes:
Consecutive
Simultaneous
Sight translation
Other (specify):
What languages?
When were you evaluated?
What were the results?
Which authority evaluated your skills?
4. Interpreting and translation training
Year:
a.
Institutions attended:
Year:
Year:
b.
Court interpreting observation (please indicate number of hours you have observed court interpreters in the courtroom setting):
c.
Legal/court interpreting training (select one):
(1)
40 or more hours of training in legal interpreting in the last 2 years
(2)
80 or more hours of training in legal interpreting in the last 4 years
(3)
Less legal training than either (1) or (2) during the identified time period
5. Teaching experience
Do you have any language teaching experience?
Yes
No
If yes, which languages?
At what levels?
Page 2 of 6
QUALIFICATIONS OF A NONCERTIFIED OR
INT-110 [Rev. January 1, 2018]
NONREGISTERED SPOKEN LANGUAGE INTERPRETER
INT-110
INTERPRETER (name):
6. Interpreting experience
a.
Have you interpreted in any court or administrative proceedings?
Yes
No
Please indicate how many proceedings or events you have interpreted in the last 6 months for each type:
Criminal
Traffic
Juvenile
Family
Small Claims
Unlawful Detainer
Civil
Probate/Conservatorship
Dates (if known):
List the last two counties you have worked in:
What languages?
Which modes of interpreting did you employ? (check all that apply):
Consecutive
Simultaneous
Sight translation
b.
Have you interpreted in any noncourt setting?
Yes
No
Please list (medical, business, education, community, other):
Number of events interpreted in the last 6 months:
Is your role as an interpreter compensated?
Yes
No
Approximate number of total days:
What languages?
Which modes of interpreting did you employ? (check all that apply):
Consecutive
Simultaneous
Sight translation
c.
Have you had 72 hours of legal interpreting experience with, or under the guidance of, a certified or registered court interpreter
mentor (includes police interpreted work, depositions, etc., as well as mock trials and other court training simulations)?
Yes
No
7.
Translation
a.
Yes
No
Do you have any experience in written translation?
b.
List types of documents:
c.
What languages?
8.
Code of professional conduct/ethics (Cal. Rule of Court, rule 2.890)
a.
Have you had any training in professional ethics for court interpreters?
Yes
No
Please explain:
b.
Have you taken the State of California's court interpreter ethics course for interpreters seeking provisional qualification?
Yes
No
(date):
(Required after the first 6-month period of provisional qualification unless you are certified or registered in a different language.)
c.
Do you have a copy of the Standards of Professional Conduct for Court Interpreters?
Yes
No
d.
Have you read, do you understand, and will you abide by the Standards of Professional Conduct for Court Interpreters?
Yes
No
9. Training in legal terminology
What training have you received in California legal terminology as required by Government Code section 68564?
Page 3 of 6
QUALIFICATIONS OF A NONCERTIFIED OR
INT-110 [Rev. January 1, 2018]
NONREGISTERED SPOKEN LANGUAGE INTERPRETER
INT-110
INTERPRETER (name):
10. Orientation to court interpreting
a.
Have you received training in criminal procedure?
Yes
No
Please describe:
b.
Have you received training in civil procedure?
Yes
No
Please describe:
c.
Have you taken the Judicial Council's online court interpreter orientation course?
Yes
(date):
No
(Required after the first 6-month period of provisional qualification unless you are certified or registered in a different language.)
11. General education
Highest level degree attained:
High school
Jr. college
University
Graduate degree
Postgraduate
N/A (No degree)
Name of institution:
Degree awarded:
Year:
Major:
Degree awarded:
Year:
Major:
12.
Language training
a.
How did you learn English? (mark N/A if not interpreting in English):
b.
How did you learn the language to be interpreted?
c.
In which languages were you educated?
Language (specify):
Elementary
Jr. high
High school
University
(1)
(2)
d.
What languages
are
were
spoken at home (specify):
13.
Disqualifications, decertifications, or criminal offenses
a.
Have you had any certifications that have lapsed or have you been disqualified from interpreting in any court or
administrative hearing?
Yes
No
Please provide detail:
b.
Have you ever been convicted of violating any federal law, state law, county or municipal law, regulation, or ordinance?
(Do not include traffic infractions.)
Yes
No
If yes, please explain:
Page 4 of 6
QUALIFICATIONS OF A NONCERTIFIED OR
INT-110 [Rev. January 1, 2018]
NONREGISTERED SPOKEN LANGUAGE INTERPRETER
INT-110
INTERPRETER (name):
INTERPRETER'S DECLARATION
Once an interpreter is provisionally qualified in one court, the relevant 6-month period applies to all courts.
Please complete this declaration based on the timing of your provisional qualification status in any California trial court.
(Check all that apply)
1.
I am unable to become certified or registered because there are no exams in my language pairing.
2.
I am 18 years of age or older.
3.
I have never been provisionally qualified or appointed to interpret in any trial court under California Rules of Court, rule 2.893.
4.
I have been provisionally qualified in a different court, and I am currently in my first 6-month period of provisional qualification
with any California trial court.
5.
I am in my second or subsequent 6-month period of provisional qualification, and I have met the specific testing and course
requirements required under rule 2.893(f)(4) or (5).
6.
Noncertified interpreters only
I have been provisionally qualified or appointed to interpret in the trial courts under California Rules of Court, rule 2.893, AND
a.
I have not exceeded any of the provisional qualification periods stated below (see Cal. Rules of Court, rule 2.893).
(1)
Two 6-month periods for noncertified Spanish interpreters in counties with a population greater than 80,000.
(2)
Four 6-month periods for noncertified Spanish interpreters in counties with a population less than 80,000.
(3)
Four 6-month periods for noncertified interpreters of designated languages other than Spanish.
b.
I have exceeded the provisional qualification periods specified in California Rules of Court, rule 2.893.
7.
Nonregistered interpreters only
I have been provisionally qualified or appointed to interpret in the trial courts under California Rules of Court, rule 2.893, AND
a.
I have not exceeded any of the provisional qualification periods stated below (see Cal. Rules of Court, rule 2.893):
(1) Four 6-month periods for nonregistered interpreters.
b.
I have exceeded the provisional qualification periods specified in California Rules of Court, rule 2.893.
I declare under penalty of perjury under the laws of the State of California that the information provided above and on the preceding pages is
true and correct. I understand that any false or misleading statements disqualify me from being considered for interpreting assignments in
the trial courts, in addition to other penalties provided by law.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF PROSPECTIVE INTERPRETER)
Page 5 of 6
QUALIFICATIONS OF A NONCERTIFIED OR
INT-110 [Rev. January 1, 2018]
NONREGISTERED SPOKEN LANGUAGE INTERPRETER

Download Form INT-110 Qualifications of a Noncertified or Nonregistered Spoken Language Interpreter - California

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