MARIN COUNTY SUPERIOR COURT 3501 Civic Center Drive, Room 113 P.O. Box 4988 San Rafael, CA 94913-4988 Application to Serve as Volunteer Civil Discovery Facilitator 1. Contact Information Name: Business address: City: Mailing address (if different): Work No.: Fax No.: Home No.: Email Address: Cell No.: State: Zip: CA State Bar No.: 2. Professional and Personal Qualifications I have been an attorney for 10 years or longer. Yes No (If you answered "no", please stop here. You are not qualified.) Date of admission to the State Bar of California: Years of active membership: I am certified as a specialist by the State Bar of California Board of Legal Specialization or by an organization whose certification program has been accredited by the State Bar of California. Areas of specialization: Are you a party to any pending criminal, civil, small claims, family law or probate proceeding in this court? (If yes, please explain in an attachment) Yes No 3. Practical Experience Describe your experience in civil litigation: Describe your familiarity with the rules of discovery: 4. Experience as a Discovery Referee Have you ever previously served as a referee? Yes No (If yes, describe your prior service.) CV056 (Rev. 11/15) APPLICATION TO SERVE AS VOLUNTEER CIVIL DISCOVERY FACILITATOR Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 5. Other Pertinent Experience I understand and acknowledge that serving as a volunteer civil discovery facilitator is solely at the discretion of the court for the purpose of assisting the public and does not constitute an employment relationship. I am aware of and will comply with all provisions of the California Rules of Court. If I am, or the firm in which I am an equity partner is, a party to any pending or impending litigation in the court, I understand that I cannot serve as a volunteer civil discovery facilitator until such cases have been disposed. If asked to serve as a volunteer civil discovery facilitator while I have cases pending, I agree to decline the appointment and notify the court. This does not apply to instances where I represent parties with pending or impending actions before the court. I declare under penalty of perjury under the laws of the State of California that the foregoing, including statements made in all attachments, is true and correct. I understand that any misstatement or omission of material fact may disqualify me from serving as a volunteer civil discovery facilitator in this court. DATE APPLICANT'S SIGNATURE CV056 (Rev. 11/15) APPLICATION TO SERVE AS VOLUNTEER CIVIL DISCOVERY FACILITATOR Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com