Fill and Sign the Deed of Assignment of Tenancy National Landlords Association Form

Print Form   OREGON JUDICIAL DEPARTMENT  Court Interpreter Services    APPLICATION FOR RENEWAL OF THE OREGON CERTIFIED COURT INTERPRETER CREDENTIAL  Please Return this form by mail to: Oregon Judicial Department Court Interpreter Services 541 NE 20th Ave #107 Portland, OR 97232   Name: Address: Home Phone Number Cell Phone Number Email Address: Renewing Certification Credential in the following language: Required Enclosures:  ⎯ Fee payment ($150.00) by check, money order or cashier’s check made payable to “Office of the  State Court Administrator.”  Visa and MasterCard payments are accepted (call 503 731‐3283)  ⎯ LEDS Record Check  ⎯ Record of Continuing Education Credit form    ⎯ Documentation of 120 hours of interpreting services in courts of record in Oregon or Consortium  member states, federal courts of record, or where the interpreter is sworn in and the record can  be presented into evidence. Documentation can include billing statements, tax forms, or the  enclosed “Interpreting Services Verification Form.”  ⎯ 1 standard‐sized passport photograph (2” x 2”)    I, the undersigned, provide information in this application which is true and accurate    _____________________________________________               ________________________   Signature                                                                                  Date    OREGON JUDICIAL DEPARTMENT  Court Interpreter Services    LAW ENFORCEMENT DATA SYSTEMS (LEDS) RECORD CHECK  Provide your Social Security number, date of birth, full name and other names and aliases. Social  Security numbers are used for a Law Enforcement Data Systems (LEDS) Record Check purposes only and  will be destroyed after the criminal record check is completed.   I hereby give my consent to the Oregon Judicial Department, Court Interpreter Services, to complete a  Law Enforcement Data Systems (LEDS) Record Check.  I understand that the finding of a relevant  criminal record may disqualify me for certification, registration or renewal as a court interpreter and  may be grounds for rejection of this application.  Signature: _____________________________________________________________    Print Full Name: ________________________________________________________  Last,  Gender:   Male______      First        Middle Initial  Female_____   Date__________________________   (For Office Use Only)     LEDS authorized user: ____________________________   Date of Inquiry: __________________________________     Records found: Yes No (Please detach portion below dotted line and destroy upon completion of LEDS entry) ------------------------------------------------------------------------------------------------------------------------------------------------------------  Social Security Number: ______________________________________    Date of Birth: ______________________________________________    Other Names and Aliases: _______________________________________________   OREGON JUDICIAL DEPARTMENT  Court Interpreter Services    RECORD OF CONTINUING EDUCATION CREDITS  In the chart below please list all of the continuing education events that you have attended and received credit for. Name  Date of Submission  Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Credits Earned _____________ Sponsor ___________________________________________ Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Credits Earned _____________ Sponsor ___________________________________________ Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Sponsor ___________________________________________ Credits Earned _____________   OREGON JUDICIAL DEPARTMENT  Court Interpreter Services    RECORD OF CONTINUING EDUCATION CREDITS Name  Date of Submission  Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Credits Earned _____________ Sponsor ___________________________________________ Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Credits Earned _____________ Sponsor ___________________________________________ Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Credits Earned _____________ Sponsor ___________________________________________ Date of Event _______________________________________ Location ____________________________________________ Title ______________________________________________ General or Language-specific ___________________________ ______________________________________________ Sponsor ___________________________________________ Credits Earned _____________   OREGON JUDICIAL DEPARTMENT  Court Interpreter Services    VERIFICATION OF INDIVIDUAL COURTROOM OR INTERPRETING TIME FOR THE OREGON CERTIFIED  COURT INTERPRETER CREDENTIAL     I verify that ____________________________________ was in the   _______________________________________________________ (Name of Court)   for __________ hours, on _______________________ performing interpreting services. (Dates or Range of Dates)   ________________________________________________________________________________________ Signature of Court Staff ____________________________________________________________________________ Name of Court Staff ________________________________________________________________________________________ Title of Court Staff Telephone Number ________________________________________________________________________________________ Date