Free Certificate of Good Standing Request - District of Columbia

UNITED STATES COURT OF APPEALS DISTRICT OF COLUMBIA CIRCUIT
333 Constitution Avenue, NW Washington, DC 20001-2866 Phone: 202-216-7000 | Facsimile: 202-219-8530

CERTIFICATE OF GOOD STANDING REQUEST FORM A certificate of good standing may be requested in writing by letter or submitting this completed form to the address above along with the certification fee of $15.00 each. Please make check payable to "Clerk, US Court of Appeals". Or you may request the certificate in person at the address above between the hours of 9:00 a.m. to 4:00 p.m. Please provide the name of the attorney who wishes the certificate and the address to which the certificate is to be mailed.

Name: Address:

Phone: Date of Admittance:

I have enclosed a check/money order in the amount of $15.00. Check/Money Order No.

USCA Form 82 August 2009 (REVISED)

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