Free IN THE UNITED STATES DISTRICT COURT - Colorado

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO APPLICATION FOR READMISSION OR REINSTATEMENT TO THE BAR OF THE COURT PURSUANT TO D.C.COLO.LCivR 83.5.I OR D.C.COLO.LCrR 57.7.I
Pursuant to D.C.COLO. LCivR 83.3 and D.C.COLO. LCrR 57.5, admission to the bar of this court is limited to those who are in good standing in all courts and jurisdictions where admitted. Pursuant to D.C.COLO. LCivR 83.5.I and D.C.COLO. LCrR 57.7.I an attorney who is not in good standing due to suspension or disbarment may apply for reinstatement or readmission utilizing the following form. 1, Name on File 2. Other Names Used: 3. Firm Name: 4. Firm Address: City: 5. Office Telephone: 6. Email Address: 7. Date First Admitted to This Court: 8. Colorado Bar Number (if applicable) ___________________________________________________________ ( ) State: Office Fax: ( ) Zip: (M ) (F )

9. Date Suspended or Disbarred by This Court 10. Give full explanation of the discipline that led to the suspension or disbarment in this court as noted in Item No. 9. Include the disciplining jurisdiction, date of discipline, type of discipline and conduct that led to discipline. Use a separate sheet if necessary. Attach documentation. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 11. W ere you disciplined by any jurisdiction other than this court and was that discipline that which led to suspension or disbarment in this court? Yes________ No________ If yes, give full explanation, including the name, address and telephone number of each disciplining jurisdiction(s), the date and type of discipline, and your current standing in each jurisdiction that disciplined you (e.g., reinstated with or without conditions; still under suspension or disbarment, etc.). Use separate sheet if necessary. Attach documentation. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

Rev. 12/05

12. Other than the discipline (if any) described in Item No. 11, have you received any discipline (including disbarment, suspension, censure or reprimand) in any jurisdiction since you were suspended or disbarred by this court? Yes ___________ No___________ If yes, indicate the jurisdiction (including address and telephone), date and nature of the discipline, and reason for the discipline. Use a separate sheet if necessary. Attach documentation. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 13. Pursuant to D.C.COLO.LCivR 83.5.I and D.C.COLO.LCrR 57.7.I, reinstatement or readmission is neither automatic nor a matter of right. Explain why the court should grant your application for reinstatement or readmission. Use a separate sheet if necessary. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 14. I consent to this court's exercise of disciplinary jurisdiction over me in connection with this application and any alleged misconduct related to my admission to and practice before the bar of this court. 15. I certify that I have read and am familiar with the local rules of this court and that I will comply with all of the provisions thereof. 16. I recognize that, if readmitted to the bar of this court, I am duty bound to give immediate written notice to the clerk of the court of any formal discipline imposed upon me, including dates and terms thereof, by any court or attorney licensing agency. 17. I solemnly swear (or affirm) that as an attorney and counselor of this court, I will conduct myself in a professional and ethical manner at all times, and I will support and defend the Constitution of the United States.

Signature Subscribed and sworn to before me this My Commission Expires: day of ,

Notary Public Submit original and one copy to: Gregory C. Langham, Clerk Attn: Secretary for Committee on Conduct United States District Court Alfred A. Arraj U.S. Courthouse, Room A-105 901 19th Street Denver, Colorado 80294-3589 Phone (303) 844-3433

Rev. 12/05