Form O. Motion and order for admission pro hac vice [Rule 71]. IN THE SUPREME COURT OF THE STATE OF DELAWARE [1] , No. [5] , 20 [2] Below, Appellant, v. [3] , [4] Below, Appellee, MOTION AND ORDER FOR ADMISSION PRO HAC VICE [6] , a member of the Delaware Supreme Court bar, pursuant to Rule 71, moves the admission pro hac vice of [7] to represent [8]in this action. Movant certifies that Movant finds the applicant tobe a reputable and admission. The applicant is admitted, practicing, and in good standing in [9]. [10] American LegalNet, Inc. www.FormsWorkFlow.com [11] hereby certifies: 1. Professional Conduct. 2. or indirectly provide services to the party or cause at issue shall be bound by all Rules of the Court. 3. That applicant has reviewed the Principles of Professionalism for Delaware Lawyers. 4. That applicant consents to the appointment of the Clerk of the Supreme Court as agent upon whom service of process may be made for all actions, including disciplinary actions, that may arise out of the practice of law under this Rule and any activities related thereto. 5. The applicant has appeared in [12] actions in courts of record of Delaware in the preceding twelve (12) months. 6. Applicant does not maintain an office in the State of Delaware except [13] . 7. That applicant is a member in good standing of the bar of the State of [14] . 8. Applicant has not been disbarred or suspended and is not the object of any pending disciplinary proceedings in any jurisdiction where the applicant has been American LegalNet, Inc. www.FormsWorkFlow.com admitted generally, pro hac vice, or any other way, except [15] . 9. Applicant is admitted for the practice of law in the following states or other jurisdictions: [16] . 10. Payment for the pro hac vice application assessment in the amount determined by the Delaware Sup reme Court Rule 72(b)(vi) is attached for d eposit in the Delaware Supreme Court registration fund to be distributed as the Supreme Court directs pursuant to Rule 71. Dated: Signature ORDER The foregoing application for admission to practice in this action pro hac vice is hereby granted. IT IS SO ORDERED this day of , . Justice American LegalNet, Inc. www.FormsWorkFlow.com Insertions to Official Form O: [1] [2] [3] [4] [5] Supreme Court appeal number. [6] [7] telephone number. [8] [9] Jurisdiction in which applying pro hac vice attorney is admitted to practice law. [10] number. [11] [12] Number of court actions in which applicant has appeared in Delaware in the preceding 12 months. [13] [14] State(s) in which applicant is admitted to practice law. [15] Instances, if any, in which applicant has been disbarred, suspended or is the object of a pending disciplinary proceeding. American LegalNet, Inc. www.FormsWorkFlow.com [16] Other jurisdictions in which applicant is admitted to practice law. American LegalNet, Inc. www.FormsWorkFlow.com