Free Application for Admission to the Bar of the United States District Court at The Southern District of Ohio - Ohio

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF OHIO
APPLICATION FOR ADMISSION TO THE BAR
I respectfully apply for admission to the bar of the United States District Court for the Southern District of Ohio, and state that I am presently a member in good standing of the bar of the Supreme Court of Ohio, and that I possess the qualifications required by the rules of this Court for admission to the bar of this Court. I certify that the above statement, and all information entered, is truthful and complete to the best of my knowledge.

SIGNED: ___________________________________________ PRINTED NAME: BUSINESS ADDRESS _____________________________________________________ _____________________________________________________ _____________________________________________________ FAX ________________________

BUSINESS PHONE ____________________ ALTERNATE ADDRESS ALTERNATE PHONE(S)

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*EMAIL ADDRESS _____________________________________________________ ADMISSION DATE OHIO BAR _____________ OHIO BAR NUMBER _____________ HAVE YOU EVER CHANGED YOUR NAME OR BEEN KNOWN BY ANY OTHER NAME OR SURNAME, OTHER THAN WHAT APPEARS ON THIS APPLICATION? YES _____ NO_____ / IF YES, PLEASE GIVE NAME AND PROVIDE DETAILS: _____________________________________________________________________________ _____________________________________________________________________________ HAVE YOU EVER BEEN DISBARRED OR SUSPENDED FROM PRACTICE BEFORE ANY COURT, DEPARTMENT, BUREAU OR COMMISSION OF ANY STATE OR THE UNITED STATES, OR HAVE YOU RECEIVED ANY REPRIMAND FROM ANY COURT, DEPARTMENT BUREAU OR COMMISSION PERTAINING TO YOUR CONDUCT OR FITNESS AS A MEMBER OF THE BAR? YES _____ NO _____ / IF YES, PLEASE PROVIDE DETAILS: ____________________ _____________________________________________________________________________
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--------------------------------------------------------------PLEASE BE ADVISED that ELECTRONIC FILING is available in the Southern District of Ohio. Unless you note otherwise below, a LOGIN ID and PASSWORD will be provided to you shortly after you are admitted to practice with our court. This will enable you to file electronically. _____________________________________________________________________________ --------------------------------------------------------------CERTIFICATION OF TWO SPONSORS
We, the undersigned members of the bar of the United States District Court for the Southern District of Ohio, do hereby certify that we are personally acquainted with the above-named applicant. We further state of our own knowledge that he/she is of good standing in the profession, of good moral character, is otherwise qualified, and in our judgment is a suitable and proper person to be admitted to the bar of this Court. PRINTED NAME OF REFERRING ATTORNEY SIGNATURE OF REFERRING ATTORNEY PRINTED NAME OF REFERRING ATTORNEY SIGNATURE OF REFERRING ATTORNEY __________________________________________ __________________________________________ __________________________________________ __________________________________________

--------------------------------------------------------------REPORT OF COMMITTEE We, the Committee on the Admission of Attorneys, having examined the above-named applicant, respectfully submit the following report: We find said applicant to be a member, in good standing, of the bar of the Supreme Court of Ohio, that he/she is of good moral character, and is otherwise qualified to practice in the United State District Court for the Southern District of Ohio as an Attorney and Counselor at Law, Solicitor in Chancery and Proctor and Advocate in Admiralty, and respectfully recommend his/her admission. Dated: __________________ Chairman: ____________________________________

FEE PAID _____ CERTIFICATE ISSUED _____ ENTERED _____