Free Application for Admission - Federal

United States Court of Appeals for the Sixth Circuit APPLICATION FOR ADMISSION TO THE BAR APPLICATION: I, , do hereby make application for admission to the bar of the United States Court of Appeals for the Sixth Circuit. My Personal statement showing my eligibility for membership is as follows: I am admitted to practice in the following court(s)

OATH: I, do solemnly swear (or affirm) that I will demean myself as an attorney and counselor of this Court, uprightly and according to law; and that I will support the Constitution of the United States of America. Signature of Applicant Subscribed and sworn to before me this day of , 20

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Signature of Notary (or Court of Appeals Deputy Clerk) FOR NOTARY: My commission expires on MOTION: I, a member of the bar of this court, do hereby move the admission of the above attorney. , 20 ,

Signature of Movant (Please print) APPLICATION INFORMATION: 9 Mr. 9 Ms. Name: (Last) Title: Firm: Address: City: Last 4 digits of SSN: Phone: State: Zip: Fax: (First) (Middle)

ADMISSION FEE: Fee for admission to the bar of this court is $200.00. Checks should be made payable to: "Clerk, U.S. Court of Appeals, Sixth Circuit". FOR CLERK'S OFFICE USE: Fee Paid: 9 Yes Comments: Admitted this day of , 20 Leonard Green, Clerk United States Court of Appeals for the Sixth Circuit By:
6CA-14 10/06

9 No

Date Paid: