Free Circuit Application for Appointment to Criminal Justice Act - Connecticut

UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT
APPLICATION FOR APPOINTMENT/REAPPOINTMENT TO CJA PANEL UNDER CRIMINAL JUSTICE ACT OF 1964 PURSUANT TO THE PLAN OF THE JUDGES OF THE SECOND CIRCUIT In answering the following questions, you may attach additional sheets. I. Name PERSONAL* _________________________________________________________

Firm Name _________________________________________________________ Office Address _______________________________________________________ _______________________________________________________ Email _______________________ Office Telephone ______________ Fax No. ___________________ Cell Phone _________________

II.

ADMISSION TO PRACTICE Year Admitted ______ Year Admitted ______ ID No. _________________** ID No. _________________ Year Admitted _____________ Year Admitted _____________ Year Admitted _____________ Year Admitted _____________

State Bar(s) ________ ___________________

Federal Bar(s) ____________________________ _________________________________________ _________________________________________ _________________________________________

*See also Confidential Information Section at pages 10-11 **Where applicable

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Are you a member in good standing of each of the Bars listed above__________? If not, please list Bar(s) in which you are no longer in good standing and explain why. _____________________________________________________________________ _____________________________________________________________________ III. EDUCATION A. Law School Attended __________________________________________ B. Dates Attended and Degree Received _____________________________ C. List Law Review or Law Journal Memberships and Authored Articles or Notes ________________________________________________________ ______________________________________________________________ D. College Attended, Degree and Date of Graduation ___________________ ______________________________________________________________ ______________________________________________________________ E. List any other Post-Graduate Degrees _____________________________ ______________________________________________________________ ______________________________________________________________ IV. WORK EXPERIENCE A. List in reverse chronological order each legal position you have held since graduating from law school. Include dates for each position. For the three most recent positions you have held within the last 15 years, list the name, address and telephone number of a supervisor or partner with whom you worked. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ -2-

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V.

PRIOR CJA EXPERIENCE A. Are you presently a member of this panel? ____________

B. Have you previously served on this panel? ____________ If so, list the dates of service. ______________________________________________________________ ______________________________________________________________ C. Approximately how many cases in the last five (5) years have been assigned to you per year during your panel service? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ D. Have you been or are you presently a member of any state appellate CJA Panel? ___________ If so, list such state appellate service with the dates of service and if terminated, state the reasons for termination. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ E. Have you been or are you presently a member of any state appellate panel? ___________ If so, list such state appellate service with the dates of service and if terminated, state the reasons for termination. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ -3-

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F. Approximately how many cases in the last five (5) years have been assigned to you per year during your other panel service? ______________________________________________________________ ______________________________________________________________ G. List any other panels in the federal courts of which you have been a member, such as the death penalty panel. If so, list any capital cases or other cases you have been assigned. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ H. With the exception of an Anders motion being granted or the retention of a private attorney by a defendant, have you ever been relieved from an assignment by the Court for any other reason? __________ If so, list the case, panel, date and reason? ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ I. Have you previously applied for appointment to this panel but were not appointed? ___________ If so, list the date of each application. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

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VI.

PREVIOUS APPELLATE EXPERIENCE A. Federal Appeals 1. Approximately how many appeals have you handled in federal criminal and federal habeas corpus proceedings during the last five years? ___________________________________________________________ ___________________________________________________________ 2. Of those, about how many were in the Second Circuit? ___________________________________________________________ 3. About how many did you handle in other circuits? ___________________________________________________________

4. List the other circuits ________________________________________ B. State Appeals 1. Approximately how many state court criminal appeals have you handled during the last five (5) years? ___________________________________________________________ C. Briefs in Most Recent Appeals* 1. List the five most recent Second Circuit appeals you have handled in criminal or habeas corpus cases. Do not include Anders cases. For each of the appeals listed, enclose a copy of your brief. Please indicate whether you represented the government, the petitioner, or the defendant; give the name and Second Circuit docket number of the case; state whether there was a written opinion or summary order, provide a case citation, and attach a copy of the opinion or order. In addition, indicate whether you wrote the brief and argued the case; and provide the names, addresses and telephone numbers of co-counsel and your opponent(s) listed on the briefs: If you have not handled five criminal or habeas corpus cases in the Second Circuit, list the most recent cases you have handled in other federal or state appellate courts.

*You m ay supplement this list with the names and briefs of any other cases you wish the CJA Co mmittee to c onsider.

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1. _____________________________________________________ _____________________________________________________ _____________________________________________________ 2. _____________________________________________________ _____________________________________________________ _____________________________________________________ 3. _____________________________________________________ _____________________________________________________ _____________________________________________________ 4. _____________________________________________________ _____________________________________________________ _____________________________________________________ 5. _____________________________________________________ _____________________________________________________ _____________________________________________________

D. If you have not handled five criminal or habeas cases in the Second Circuit in the last five years, how many civil appeals have you handled in the Second Circuit or any other federal circuit in the last five (5) years? ____________ Please list these cases including the name of the case and docket number. 1. _____________________________________________________ 2. _____________________________________________________ 3. _____________________________________________________

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VII.

FOREIGN LANGUAGES A. Do you speak any foreign languages? _____________ If so, list the foreign languages you speak, state whether you can read any of the foreign languages and describe your level of fluency. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

VIII. FEDERAL RULES; CLE A. Are you familiar with Title 18 and the habeas corpus provisions of Title 28 of the United States Code, the Federal Rules of Appellate Procedure, the Second Circuit Local Rules, the Federal rules of Criminal Procedure and the Sentencing Guidelines? _____________________________________ B. Are you in compliance with the CLE requirements as required by the State(s) in which you are admitted? _____________ If not, please explain. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

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1. Have you attended CLE or other training programs focusing on federal criminal and federal appellate practice during the last three (3) years? _____________ If so, please list the programs you have attended or participated in during that time period. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

IX.

OTHER EXPERIENCE A. List any other legal experience which you feel might be helpful in evaluating your competence to serve on this panel. Where appropriate, include the names, addresses and telephone numbers of adversaries, cocounsel and judges.

X.

REFERENCES A. Please list three references who can assess your skills relevant to this panel. Name Address Telephone No.

1. ____________________________________________________________

2. ____________________________________________________________

3. ____________________________________________________________

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CERTIFICATION

Under the penalties of perjury, I certify that the information contained in this application including the attachments are true and accurate to the best of my knowledge. I also certify that I understand that with the exception of the information contained in the "Personal and Confidential" Section of this Application, this application will not be confidential and will be kept as a public record with the Clerk of Court of the United States Court of Appeals for the Second Circuit.

_______________ Date

______________________________ Applicant's Signature

Submit an original, plus 3 paper copies of the completed application and your resumé . In addition, send a diskette, containing both application and resumé to: Office of the Clerk of the Court
Thurgood Marshall United States Courthouse 40 Centre Street

New York, New York 10007 Phone 212-857-8702 Application packages must be received by 5:00 P.M. on Monday, April 21, 2008.

N.B.

If you change your address, or if anything occurs that would affect your answers to this application, notice of such change should be sent to Clerk of Court, Catherine O'Hagan Wolfe.

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UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT
APPLICATION FOR APPOINTMENT/REAPPOINTMENT TO CJA PANEL UNDER CRIMINAL JUSTICE ACT OF 1964 PURSUANT TO THE PLAN OF THE JUDGES OF THE SECOND CIRCUIT

PERSONAL AND CONFIDENTIAL INFORMATION

Name ________________________________________________________________

A.

Have you ever been arrested, charged or convicted of a crime under any federal, state of local law? ___________ If so, give the details. Do not include traffic violations punished only by a fine of $200 or less. __________________________________________________________ __________________________________________________________ __________________________________________________________

B.

Have you, to your knowledge, ever been the target of a federal, state or local investigation for possible violation of a criminal statute? __________ If so, please give particulars. __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________

C.

Have you ever been held in contempt or been the subject of a contempt proceeding? _____________ If so, give the particulars. __________________________________________________________ __________________________________________________________ __________________________________________________________

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D.

Have you ever been disciplined, sanctioned or cited for a breach of ethics or unprofessional conduct by any court, administrative agency, bar association or other professional group or, without regard to the outcome, to your knowledge has there ever been a complaint against you with or by any court, administrative agency, bar association or other professional group? ______________ If so, please provide details. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

E.

Have you ever been criticized in a judicial opinion? Please furnish a copy. If you wish to do so, you may attach an explanatory statement. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

F.

State whether in the last 5 years (a) you have suffered from alcoholism or addiction to any drug or medication, or (b) the use of alcohol, drugs or medication has affected your work. If so, provide particulars. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

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