United States Court of Appeals for the Ninth Circuit
P.O. Box 193939 San Francisco, California 94119-3939
APPLICATION AND OATH FOR ADMISSION
PERSONAL STATEM ENT Name (Last, First, Middle): Firm Name or Agency Street Address Mailing Address (if different from above) Phone BAR INFORM ATION Federal/State Admissions Fax City City Email State State Zip Zip Social Security # Date of Birth
Answer each question. If any answer is yes, attach a statement providing details. 1. 2. 3. 4. Have you been known by any name other than that appearing on the application? Have you ever been disbarred or suspended from practice before any court or government agency? Are any such actions pending against you? Are you currently under investigation by, or have you ever received a reprimand from any court or government agency?
OATH I, , certify under penalty of perjury under the laws of the United States (Name as you want it to appear on your certificate) of America that the foregoing is true and correct. I do solemnly swear [or affirm] that I will conduct myself as an attorney and counselor of this Court, uprightly and according to law; and I will support the Constitution of the United States. Signature of Applicant Date
M OTION FOR ADM ISSION This section must be completed by a sponsor in good standing with the Ninth Circuit Court of Appeals unless you attended a mass swearing-in ceremony. Check here if you attended a mass swearing-in ceremony. I, , a member in good standing of the Bar of the United States Court of Appeals (Full name of sponsor) for the Ninth Circuit, hereby move the admission of to the Bar of this Court. I am satisfied that the applicant possesses the qualifications set forth by Federal Rules of Appellate Procedure 46(a).
Signature of Sponsor
Send form and fee to Attorney Admissions, U.S. Court of Appeals, P.O. Box 193939, San Francisco, CA 94119-3939. Overnight courier services deliver to: 95 Seventh Street, San Francisco, CA 94103-1518. The admission fee is $190.00 payable to "Clerk, U.S. Court of Appeals." Rev. June 2009