Free pdf - Vermont


File Size: 177.2 kB
Pages: 2
Date: July 15, 2004
File Format: PDF
State: Vermont
Category: Court Forms - Federal
Author: mhd
Word Count: 244 Words, 2,182 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.vtd.uscourts.gov/Supporting%20Files/atyadm2.pdf

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UNITED STATES DISTRICT COURT FOR THE DISTRICT OF VERMONT APPLICATION FOR ADMISSION

Name ____________________________________________________ SS#_______________ (First) (Middle) (Last) Telephone - Office __________________________ Home ______________________________ Firm Name ____________________________________________________________________ Office Address _________________________________________________________________ Residence Address ______________________________________________________________ E-mail Address I have been admitted to practice in and am now in good standing before the following named courts and have not been the subject of disciplinary proceedings in any jurisdiction: ____________________________________ ____________________________________ ____________________________________ ____________________________________

My Sponsor is ________________________________. I do solemnly swear (or affirm) that I will act as an ATTORNEY AND COUNSELOR of this Court, uprightly and accordingly to law; and that I will support the Constitution of the United States. So help me God. I declare under penalty of perjury that this foregoing is true and correct. ___________________________________ Subscribed and sworn to before me this ______ day of ___________________, _________ ___________________________________ (Deputy Clerk)
For Office Use Only Place of Admission Date of Admission Judge Receipt Rule Book

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF VERMONT

ADDENDUM to APPLICATION FOR ADMISSION
To be completed by Vermont resident attorneys only:

Name ___________________________________________________________ (First) (1) (Middle) (Last)

I am willing to be contacted to represent indigent plaintiffs in civil cases: Yes No If Yes, type of cases preferred: Prisoner - Conditions of Confinement Prisoner - Habeas Corpus Employment Discrimination Social Security Other (please specify):

(2)

I am willing to represent indigent parties in bankruptcy-related matters: Yes No

(3)

I would like to be considered for admission to the Court's standing Criminal Justice Act (CJA) Panel. (Note separate requirements as per CJA Plan Section VI(3)) Yes No