Authority To Practice

COMMONWEALTH OF PENNSYLVANIA GOVERNOR'S OFFICE PENNSYLVANIA HUMAN RELATIONS COMMISSION In the matter of: Case No.: Appearing on Behalf of: AUTHORITY TO PRACTICE ( ) 1. I am an attorney at law admitted to practice before the Supreme Court of Pennsylvania, and my Supreme Court I.D. No. is____________. ( ) 2. I am an attorney at law admitted to practice before the highest court of another jurisdiction. If Item 2 has been checked, and you are claiming a right to practice before the Pennsylvania Human Relations Commission under the reciprocity provision of 1 Pa. Code §31.22, please complete the NOTICE OF RECIPROCITY, have your client complete the attached POWER OF ATTORNEY, and submit them with this form and your NOTICE OF APPEARANCE. If Item 2 has been checked, and your are not claiming a right to practice before the Pennsylvania Human Relations Commission under the reciprocity provision of 1 Pa. Code §31.22, please complete the NOTICE OF FOREIGN ATTORNEY STATUS, have your client complete the attached POWER OF ATTORNEY, and submit them with this form and your NOTICE OF APPEARANCE. ____________________________________ Signature ____________________________________ Name (Printed) ____________________________________ P.O. Address ____________________________________ City, State, and Zip Code ____________________________________ Telephone (including area code) ____________________________________ Date American LegalNet, Inc. www.FormsWorkFlow.com