State of Alabama
Unified Judicial System
Form FIS-1 8/06
INTERPRETER
CLAIM FOR EXPENSES
FEES & TRAVEL
Do not write in this space
_______________________
Voucher Number
_______________________
Date
_______________________
Code
Section A: CASE/APPOINTING AUTHORITY
Case Number(s) ________________________________
Style of Case(s) ________________________________
______________________________________________
Court (or Other Appointing Authority) County
______________________________________________
Address
______________________________________________
City State Zip Code
Area Code ( )
Telephone Number
SSN __ __ __ __ __ __ __ __ __
NAME __________________________________________________________
ADDRESS _______________________________________________________
CITY _______________________________ ST ___________ ZIP __________
Name, Address, SSN of the Interpreter
Hearting Impaired Foreign Language
Section B: Transportation/Travel
Date From To Purpose
*Miles
Traveled
TOTAL
Fare or Travel
B. Sub-Total Transportation
$
Section C: Expenses/Fees
Date Breakfast Lunch Dinner Room Miscellaneous (Explain) **Fee TOTAL
C. Sub-Total Expenses & Fees $
*An interpreter may claim mileage at the rate allowed by state law.
**The fee for hearing impaired shall be in accordance with standards established by the Alabama Registry of
Interpreters for the Deaf, plus actual expenses.
The fee for foreign language is $ 25 per hour plus travel & transportation expenses
GRAND TOTAL
Section B & C
$
Section D : APPROVAL Section E : CERTIFICATION
The actual expenses incurred and compensation as stated above by the
interpreter while on active call are hereby approved for payment.
__________________ ___________________________________
Date Signature of Appointing Authority
___________________________________
Title
I certify that the above account in the amount of $ ______________
is correct, due, and unpaid.
______________________________________________________
Interpreter’s Signature Date
Sworn to and subscribed before me this
(date) ________________________________________________
_____________________________________________________
Notary Public
Interpreter’s Certification Level _____________________________
(hearing impaired only)
See Reverse Side for
Filling Mailing Instructions
INSTRUCTIONS
CLAIMS FOR PAYMENT ARE SUBMITTED TO:
STATE COMPTROLLER
P.O.BOX 302602
MONTGOMERY, AL36130-2602
Attention: Interpreter Claims