Travel Agency Invoice

REQUEST FOR PAYMENT OF INTERPRETER SERVICES IN INDIGENT MATTER Remit To: Administrative Office of the Courts, Fiscal Division, Nashville City Center, Suite 600, 511 Union Street, Nashville, TN 37219 Phone (615) 741-2687 INTERPRETER TAXPAYER ID (OR SS ): 874-39-5789 LANGUAGE: Korean INTERPRETER NAME / ADDRESS / CITY / STATE / ZIP CODE / TELEPHONE NUMBER/ E-MAIL ADDRESS (PLEASE PRINT) Mary Jones, 342 Smith Street, Springfield, TN 37907 (555) 555-5555, Mary.Jones hotmail.com THIS IS A SAMPLE INVOICE CREDENTIALS: CHECK ONE CERTIFIED REGISTERED X NON-CREDENTIALED DEFENDANT NAME CASE NO(s).. Assault Davidson Criminal Court Division I SERVICE DATE ACTIVITY HOURS (IN TENTHS) or WORDS x RATE = TOTAL EXPENSES 1/3/06 Transcribed surveillance tapes of conversation between defendant and undercover office 3.2 hrs.. = 52.50 1/12/06 Parking at court 3.00 COLUMN TOTALS HOURS: 9.0 hours WORDS: 120 words TOTAL: 249.00 TOTAL EXP: 64.80 I certify that the foregoing represents an accurate, complete statement of time and expenses in connection with the above action or proceedings.. Signature of Interpreter DATE Printed Name of Judge Signature of Judge DATE INDIVIDUAL DEFENDANT SAMPLE INVOICE EXPLANATION (THIS ONLY APPLIES TO WORK PERFORMED ON OR AFTER JULY 1, 2004) PLEASE NOTE: You must be VERY specific when you are describing your activities..