Free Disclosure of Corporate Affiliations Statement - Federal

UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT DISCLOSURE OF CORPORATE AFFILIATIONS AND OTHER INTERESTS Only one form needs to be completed for a party even if the party is represented by more than one attorney. Disclosures must be filed on behalf of all parties to a civil, agency, bankruptcy or mandamus case. Corporate defendants in a criminal or post-conviction case and corporate amici curiae are required to file disclosure statements. Counsel has a continuing duty to update this information.

No. _______

Caption: __________________________________________________

Pursuant to FRAP 26.1 and Local Rule 26.1, ______________________ who is _______________________, makes the following disclosure: (name of party/amicus) (appellant/appellee/amicus) 1. 2. Is party/amicus a publicly held corporation or other publicly held entity? YES Does party/amicus have any parent corporations? YES If yes, identify all parent corporations, including grandparent and great-grandparent corporations: NO NO

3.

Is 10% or more of the stock of a party/amicus owned by a publicly held corporation or other publicly held entity? YES NO If yes, identify all such owners: Is there any other publicly held corporation or other publicly held entity that has a direct financial interest in the outcome of the litigation (Local Rule 26.1(b))? YES NO If yes, identify entity and nature of interest: Is party a trade association? (amici curiae do not complete this question) YES NO If yes, identify any publicly held member whose stock or equity value could be affected substantially by the outcome of the proceeding or whose claims the trade association is pursuing in a representative capacity, or state that there is no such member: Does this case arise out of a bankruptcy proceeding? If yes, identify any trustee and the members of any creditors' committee: YES NO

4.

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6.

CERTIFICATE OF SERVICE
************************** I certify that on this date I served this document on all parties as follows:

_______________________________ (signature)

________________________ (date)

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