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Language Access Request Form

If you need language access assistance from Agricultural Commissioner / Weights and Measures when accessing public services or information offered by the department, you can submit a request.

Section 1: Requestor Information

MM slash DD slash YYYY
Name of Requestor
Relationship to Individual Needing Assistance

Section 2: Individual Requiring Language Assistance

Name
MM slash DD slash YYYY
Preferred Method of Communication

Interpreter/Translator Gender Preference

Section 3: Service Requested

Type of Language Assistance Needed