Voluntary Request For Transfer License From Inactive To Active

STATE BAR OF NEVADA Member Services 3100 W. Charleston Blvd., S ui te 100 Las Vegas, NV 89102 (702) 382 - 2200 or memberservices@nvbar.org Voluntary Request for SCR 98.7 Transfer to Active Status T rans fer s from January 1 March 1 : $40 CLE fee must be paid to SBN . T rans f er s from March 2 Octo ber 31: $ 4 0 CLE fee must be paid to the C LE B oard. T rans fers from November 1 December 31: contact SBN prior to submitting. T h is form is not to be use d to update your contact in formation. A chan ge of address form is available on the Library of Forms page of our website at www.n vbar.org. Bar No.: Member Name: Phone Number: E - mail: SCR 79 Address: City: , State: Zip: I hereby request that I be enrolled as an ACTIVE member of the State Bar of Nevada in accordance with SCR98.7 effective / / . Status change will not be effective until receipt of this form, payment in full and all required disclosures have been submitted. Payment of $1 registration fee , full annual membership fee for an active member, and applica ble CLE fee for the current calendar year less any license fee paid as an inactive member for such year is required. Requirements: I have contacted the CLE Board to ensure I am in compliance, 775 - 329 - 4443. Enclosed is my check, payable to the State Bar of Nevada, or I have paid via credit card . Enclosed is my trust account reporting form (Certification of Compliance and Consent). Enclosed is my insurance disclosure . Enclosed is my Change of Address form or I have updated my contact information online . S ignature (Signature stamps will not be accepted.) Date FOR OFFICIAL USE ONLY American LegalNet, Inc. www.FormsWorkFlow.com