SDSC ADM-153 (Rev.6/18) APPLICATION TO SERVE AS TEMPORARY JUDGE Page 1 of 6 AND/OR SETTLEMENT ATTORNEY 0 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO APPLICATION TO SERVE AS TEMPORARY JUDGE AND/OR S ETTLEMENT ATTORNEY a. Name: b. California State Bar number: c. Business address: City: Mailing address (if different): City: State: Zip Code: d. Email: e. Telephone numbers: Daytime: Evening: Fax: Cell (optional): f. Emergency notification information:Name: Tel No.: Relationship: Address: City: State: Zip Code: 2. Areas of Interest a. I am willing to serve as a court-appointed temporary judge and/or settlement attorney at the court locations and for the case types indicated below. CENTRAL (Downtown): CENTRAL (KMF): EAST: NORTH: SOUTH: Family Settlement Traffic Family Settlement Family Settlement Family Settlement Family Support Division Traffic Traffic Probate Small Claims b. I am available to serve the following days and times: Monday Tuesday Wednesday Thursday Friday Morning Afternoon Evening Assignments on short notice Other (describe): c. I am not available to serve as follows (describe and explain): American LegalNet, Inc. www.FormsWorkFlow.com APPLICANT222S NAME STATE BAR NUMBER SDSC ADM-153 (Rev. 6/18) APPLICATION TO SERVE AS TEMPORARY JUDGE Page 2 of 6 AND/OR SETTLEMENT ATTORNEY 3. Professional and Personal Qualifications a. Date of admission to the State Bar of California: Years of active membership: b. I am also admitted to practice law in the states listed below: State: Date admitted: Bar No: Years of active membership: State: Date admitted: Bar No: Years of active membership: c. Are you in good standing in each state where you are licensed to practice law? Yes No (If no, provide an explanation in Attachment 3c.) d. 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: e. I am certified as a legal specialist by other states or organizations as follows (specify): Areas of specialization: f. If you applied to hear family settlement conferences, you must self-certify that you are in compliance with all applicable requirements set forth in Eligibility and Training Requirements for Temporary Judges/Settlement Attorneys (SDSC Form #ADM-009) and Temporary Judge and Settlement Attorney Checklist of Requirements (SDSC Form #ADM-020). I am in compliance I am not in compliance I have not applied to hear family settlement conferences g. Have you ever been disciplined by the State Bar of California or by a bar association or other professional licensing entity in any state or by a court of record, including being sanctioned or held in contempt? Yes No h. Do you have any disciplinary action pending against you by the State Bar of California or by a bar association or other professional licensing agency in any state or by a court of record, including any proceeding for the imposition of sanctions or for contempt? Yes No i. Have you ever been convicted or pleaded no contest to a felony or misdemeanor? Yes No j. Are you a defendant in any pending felony or misdemeanor proceeding? Yes No k. Have you ever been a party to any legal proceeding? Yes No (If you answered yes to questions 3g, h, i, j, or k, provide additional information in an attachment.) l. Are you a debtor on any outstanding sanctions or civil judgments? (If yes, explain.) 4. Practical Experience a. The principal portion of my law practice in California is in the following courts (specify state and federal courts, including trial and appellate courts, if applicable): b. I currently practice in the following areas of law (list each subject area of law that occupies at least 10 percent of your time): American LegalNet, Inc. www.FormsWorkFlow.com APPLICANT222S NAME STATE BAR NUMBER SDSC ADM-153 (Rev. 6/18) APPLICATION TO SERVE AS TEMPORARY JUDGE Page 3 of 6 AND/OR SETTLEMENT ATTORNEY c. Do you hold yourself out publicly as representing exclusively one side in any area of litigation practice? Yes No (If yes, provide the following information): Area of Practice Side Represented d. Do you represent one side in more than 90 percent of your cases in any area of litigation practice? Yes No (If yes, provide the following information): Area of Practice Side Represented 5. Experience as a Temporary Judge and/or Settlement Attorney a. Have you previously served as a temporary judge and/or settlement attorney? Yes No (If yes, describe in Attachment 5a your prior service. Include the names of the courts and the locations where you served, the approximate number and types of matters heard, and the approximate dates of service.) b. Have you been removed by a court as temporary judge and/or settlement attorney? Yes No (If yes, describe the circumstances in Attachment 5b. Include the court, the date you were removed, and the reasons for your removal.) 6. Training Describe any training that you have received that qualifies you under Cal. Rules of Court, rule 2.812, et seq. to serve as a court-appointed temporary judge and/or settlement attorney, including the subjects, the dates, and the name of the court or other provider of the training: a. Bench conduct (describe): b. Ethics (describe): c. Small claims (describe): d. Traffic (describe): e. Other (describe): Continued on Attachment 6. American LegalNet, Inc. www.FormsWorkFlow.com APPLICANT222S NAME STATE BAR NUMBER SDSC ADM-153 (Rev. 6/18) APPLICATION TO SERVE AS TEMPORARY JUDGE Page 4 of 6 AND/OR SETTLEMENT ATTORNEY 7. Additional Information Respond to the following, if applicable: a. The following facts concerning my background, situation, or circumstances may positively or negatively reflect on me or on my suitability for appointment and should be disclosed to the court. Continued in Attachment 7a. b. I ask the court to consider the following additional facts in support of my appointment: Continued in Attachment 7b. 8. Contact Persons It may be necessary to contact you about your service as a temporary judge and/or settlement attorney. List two individuals who will always know your whereabouts. a. Name: First Last Business address: City: State: Zip Code: Business telephone no.: ( ) Email: b. Name: First Last Business address: City: State: Zip Code: Business telephone no.: ( ) Email: 9. References List up to three professional references including at least two judicial officers/commissioners (a letter of recommendation from at least one of the judicial officers/commissioners should accompany the application): American LegalNet, Inc. www.FormsWorkFlow.com APPLICANT222S NAME STATE BAR NUMBER SDSC ADM-153 (Rev. 6/18) APPLICATION TO SERVE AS TEMPORARY JUDGE Page 5 of 6 AND/OR SETTLEMENT ATTORNEY 10. I understand and acknowledge that the selection and appointment of a temporary judge and/or settlement attorney is solely at the discretion of the court for the purpose of assisting the public. 11. I understand and agree that policies concerning defense and indemnification, as well as workers222 compensation coverage, of temporary judges and/or settlement attorneys are set by the legislature and implemented by state organizations other than the San Diego Superior Court. I further understand and agree that my service as a volunteer temporary judge and/or settlement attorney does not constitute an employment relationship or entitle me to compensation or benefits from the San Diego Superior Court. 12. Check the box below if you are currently a court employee: I understand and acknowledge that all volunteer work I perform on behalf of the Superior Court222s temporary judge/settlement attorney program is not required, is not part of my job duties, is outside my regular job classification as an employee, and is separate from any paid work responsibility. 13. I understand that before I am eligible to serve as a temporary judge and/or settlement attorney, I will be required to complete the Background Investigation Form (SDSC Form #ADM-064) and undergo a local background investigation. If I clear the local background check, I will then be required to complete a Request for Live Scan Service (DOJ Form #