Application And Order For Admission Pro Hac Vice

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO ___________________________________ Plaintiff v. ___________________________________ Defendant APPLICATION AND ORDER FOR ADMISSION PRO HAC VICE Comes now, ________________________________, applicant herein and respectfully states: 1. Applicant is an attorney and a member of the law firm of (or practices under the name of _____________________________________________________________, with offices at: Address Case No. _________________ Email Telephone No. Fax No. 2. Applicant will sign all pleadings with the name _______________________________. 3. Applicant has been retained personally or as a member of the above-named firm by _________________________________ to provide legal representation in connection with the above-styled matter now pending before the United States District Court for the District of Puerto Rico. 4. Since _____________________, applicant has been and presently is a member in good standing of the bar of the highest court of the State of _____________________, where applicant regularly practices law. Applicant's bar license number is _________________. Application and Order for Admission Pro Hac Vice (10/2003) Note: This form is provided for illustrative purposes only. You must consult the Local Rules prior to submission of this or any other pleading to the Court to ensure proper compliance. Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com 5. Applicant has been admitted to practice before the following courts: Court: Admission Date: 6. Applicant is a member in good standing of the bars of the courts listed in paragraph 5. 7. Applicant is not currently suspended from the practice of law before any court or jurisdiction. 8. Applicant is not currently the subject of any complaint for unethical conduct, disciplinary proceeding or criminal charges before any court or jurisdiction. 9. During the past three years, applicant has filed for pro hac vice admission in the United States District Court for the District of Puerto Rico, in the following matters: Date of Application: Case Number and Style: 10. Local counsel of record associated with applicant in this matter is: Name USDC-PR Bar No. Address Email Telephone No. Fax No. Application and Order for Admission Pro Hac Vice (10/2003) Note: This form is provided for illustrative purposes only. You must consult the Local Rules prior to submission of this or any other pleading to the Court to ensure proper compliance. Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com 11. Applicant has read the local rules of this court and will comply with same. 12. Applicant has read Local Rules of the United States District Court for the District of Puerto Rico which provide in part that attorneys appearing pro hac vice must comply with the provisions set forth therein and pay an admission fee of $150 per appearance in each new case before the Court. Accordingly, payment of the pro hac vice admission fee is attached hereto in the form of a check or money order payable to: "Clerk, U.S. District Court." WHEREFORE, applicant respectfully requests to be admitted to practice in the United States District Court for the District of Puerto Rico for the above-styled case only. Date: __________________________________. ____________________________ Printed Name of Applicant ____________________________ Signature of Applicant I HEREBY CERTIFY, pursuant to Local Rule 83.1(f), that I consent to the designation of local counsel of record for all purposes. Date: __________________________________. ____________________________ Printed Name of Local Counsel ____________________________ Signature of Local Counsel Application and Order for Admission Pro Hac Vice (10/2003) Note: This form is provided for illustrative purposes only. You must consult the Local Rules prior to submission of this or any other pleading to the Court to ensure proper compliance. Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com I HEREBY CERTIFY that I have served a true and correct copy of this document upon each attorney of record and the original upon the Clerk of Court accompanied by a $150.00 pro hac vice admission fee. ____________________________ Signature of Applicant ORDER The Court, having considered the above Application for Admission Pro Hac Vice, orders that: ` the application be granted. The Clerk of Court shall deposit the admission fee to the account of Non-Appropriated Funds of this Court. ` the application be denied. The Clerk of Court shall return the admission fee to the applicant. SO ORDERED. In San Juan, Puerto Rico, this ________ day of _________________, _______. ____________________________ U.S. DISTRICT JUDGE Application and Order for Admission Pro Hac Vice (10/2003) Note: This form is provided for illustrative purposes only. You must consult the Local Rules prior to submission of this or any other pleading to the Court to ensure proper compliance. Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com