Application For Special Masters

APPLICATION FOR SPECIAL MASTERS (Form Must be Typed) The District Court requires that applicants have at least 10 years of practice in Connecticut and specialized experience within one or more identifiable areas of law in order to meet the minimum qualifications for appointment to Special Master. PLEASE COMPLETE THE FOLLOWING INFORMATION: Name: Firm Name: Address: Telephone: E-mail: CT Federal Bar Number: Please indicate your years of experience: Please indicate experience nature and date of prior state or federal ADR years of experience (including Special Master service): American LegalNet, Inc. www.FormsWorkFlow.com Who do you primarily represent: Plaintiff(s) Defendant(s) Both Please indicate your areas of specialized experience: EXPERTISE Contract Tort Employment Labor ERISA Civil Rights Unfair Trade/Antitrust Securities Banking Tax Patent Trademark/Copyright Consumer/Fair Debt/ Truth in Lending Insurance Environmental Admiralty/ Maritime Other: Please list two members of our bar on whose cases you served as a settlement neutral: TYPE OR SUB-SPECIALTY Rev. 1/7/2013 American LegalNet, Inc. www.FormsWorkFlow.com