Free Attorney Annual Registration Form 2009/2010 - Kansas

UNITED STATES DISTRICT COURT DISTRICT OF KANSAS ANNUAL REGISTRATION JULY 1, 2009 THROUGH JUNE 30, 2010 DUE DATE: July 1, 2009

ATTORNEY ADDRESS INFORMATION

Please check here if your address has changed since the previous registration period Please print or type

KS Bar#: Last: Firm Name: Street Address: City/State Office Phone (Main Number): Email address:

Date of Birth: First: M.I.: Generation (ie. Jr., III)

Suite Number: Zip Code: Private Extension Fax

ACTIVE STATUS

Pursuant to the rules of this court, I hereby register as an active member of the bar of the United States District Court for the District of Kansas for the 12-month period beginning July 1, 2009.

I certify that: 1. I am now a member in good standing of the bar of this court; and 2. I am currently registered as an active attorney in (place a check mark next to one or both as appropriate): Kansas Western District of Missouri ; and If not, please explain why you should be registered in the US District Court ________________________________ ___________________________________________________________________________________________________ 3. To my knowledge there are NO disciplinary or suspension proceedings pending against me in any court of the United States or of any state, territory or possession of the United States; and NOTE: If proceedings ARE pending at this time, please include an explanation with this form. 4. During the 12-month period preceding the date of this application I have earned the required credit hours of continuing legal education and am in compliance with the CLE rules of (place a check mark next to one or both as appropriate): Kansas Western District of Missouri ; and 5. I have taken the oath or affirmation prescribed by the rules of this court and acknowledge that I remain bound thereby; and 6. I have read and am familiar with the Rules of Practice and Procedure of this court.

05/28/2009
Signature Date

ACTIVE STATUS (CONTINUED)

An ANNUAL FEE of $50.00 is required of all attorneys to practice law before this Court. To assure proper registration please mail this form with payment to:

Clerk, US District Court P.O. Box 2219 Topeka, KS 66601-2219
Make checks payable to: Clerk, U.S. District Court

CIVIL PRO BONO PANEL

Sign below to register for the Civil Pro Bono Panel. Attorneys are encouraged to provide pro bono services to the public when permitted. The court is selective in making appointments and attorneys will not be burdened with multiple appointments. Pro bono service is a great means of getting to trial, especially for young lawyers.

By signing below I agree to serve on the Civil Pro Bono Panel and realize that on occasion the court may appoint counsel for indigent parties in civil litigation. As a member of the panel I understand that I may be reimbursed for out-of-pocket expenses which the client is not able to pay according to the Reimbursement Procedures for Court-Appointed Counsel in Civil Cases pursuant to D. Kan. Rule 83.5.3(e)(2) and (f). These expenses include items set out in 28 U.S.C. 1920, fees for expert witnesses and other out-of-pocket expenditures which counsel are reasonably compelled to incur and which are not otherwise recoverable in the action, but no reimbursement shall be made for general office overhead or items and services of a personal nature. To qualify for reimbursement, all expenditures must be approved in advance. ________________________________________ Signature

INACTIVE STATUS

Complete this section ONLY if you are requesting to be placed on "INACTIVE" STATUS.

I wish to be placed on "inactive" status at this time. I understand I may not practice in this Court while on "inactive" status. In addition, I do not have to pay an annual fee while on "inactive" status.

05/28/2009
Signature Date

2010 LOCAL RULES

Please indicate your preference regarding a bound copy of the 2010 Local Rules for the District of Kansas. REMINDER: The most current version of the court's Local Rules is available on the court's website at www.ksd.uscourts.gov.

I wish to receive a bound copy of the court's Local Rules. I DO NOT wish to receive a bound copy of the court's Local Rules.

Please e-mail questions to: [email protected] NOTE: The District of Kansas reserves the right to use information provided on this form to develop an on-line registration system. By completing this registration form, you acknowledge that the information you provide may be incorporated into such a system. The District of Kansas does not sell, share or rent information to anyone outside of the court.

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