Notice of Attorney Appearance And Counsel Contact Information

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF WEST VIRGINIA NOTICE OF ATTORNEY APPEARANCE AND COUNSEL CONTACT INFORMATION FORM Select all that apply: MDL No. 2187 | In Re C. R. Bard, Inc., Pelvic Repair System Products Liability Litigation MDL No. 2326 | In Re Boston Scientific Corp. Pelvic Repair System Products Liability Litigation MDL No. 2387 | In Re Coloplast Corp. Pelvic Support Systems Products Liability Litigation MDL No. 2511 | In Re Neomedic Pelvic Repair System Products Liability Litigation Civil Action Number (SDWV): (To MDL No. 2325 | In Re American Medical Systems, Inc., Pelvic Repair System Products Liability Litigation MDL No. 2327 | In Re Ethicon, Inc., Pelvic Repair System Products Liability Litigation MDL No. 2440 | In Re Cook Medical, Inc., Pelvic Repair System Products Liability Litigation be filed electronically in each member case noted. DO NOT FILE IN MAIN MDL CASE.) Please Print or Type Below ATTORNEY INFORMATION Check One: Last Name Bar Number and State: Party Representing: Plaintiff Counsel Defense Counsel First Name E-Mail Address: Third Party Defense Counsel Middle Name/Maiden Suffix Originating Case Number: Originating Short-Case Style: Direct Dial Number: Secretary Name: Originating District: Cell Phone Number: Paralegal Name: LAW FIRM INFORMATION Firm Name: Address: City: Firm Phone Number: Other members of firm involved in this litigation: State: Firm Fax Number: Zip: s/ Date Electronic Signature Rev. 02/14 American LegalNet, Inc. www.FormsWorkFlow.com