s Family Name (Last Name) 1.b. Interpreter's Given Name (First Name) 2. Interpreter's Business or Organization Name (if any) Form 1.765 12/26/19 Ill Walgialealrefiktffittailfeiallfill Page 4 of 7 EFTA01699789 Part 4. Interpreter's Contact Information, Certification, and Signature Interpreter's Mailing Address 3.a. Street an