CIV103 State ENG Rev 7/18www.mncourts.gov/formsPage 1 of 2State of Minnesota District Court County of:Select County Judicial District: Court File Number: Case Type: Plaintiff (first, middle, last) Defendant (first, middle, last)vs.Motion for Admission of Pro Hac Vice I, , an active member ingood standing of the bar of the State of Minnesota, move that this Court admit pro hac vice, , an attorney admitted to practice in thetrial courts of , but not admitted to the bar of this Court, who will be counsel for the Plaintiff Defendant in this case. I am aware that Rule 5of the Minnesota General Rules of Practice requires me to (1) sign all pleadings in this case, (2) be present in person or by telephone at the proceeding at which this Motion is heard, and (3) be present in person or by telephone at all subsequent proceedings in this case unless the Court, in its discretion, conducts the proceedings without the presence of Minnesota counsel.I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Signature Dated: Name: MN Attorney License No. Law Firm Name: Address: City/State/Zip: Telephone: E-mail address: County and State where signed American LegalNet, Inc. www.FormsWorkFlow.com CIV103 State ENG Rev 7/18www.mncourts.gov/formsPage 2 of 2Affidavit of Proposed Admittee I, , am currently admitted to practiceand in good standing in the trial courts of the following jurisdiction(s), but not admitted to the bar of this Court: State License # Status Admission Date I understand that if this Court grants me admission pro hac vice, Rule 5 of the Minnesota General Rules of Practice requires the Minnesota lawyer bringing this Motion to (1) sign all pleadings in this case, (2) be present in person or by telephone at the proceeding at which this Motion is heard, and (3) be present in person or by telephone at all subsequent proceedings in this case unless the Court, in its discretion, conducts the proceedings without the presence of Minnesota counsel. I also understand that Rule 5 of the Minnesota General Rules of Practice specifies that by appearing pursuant to that rule I am subject to the disciplinary rules and regulations governing Minnesota lawyers and that by applying to appear or appearing in any action I am subject to the jurisdiction of the Minnesota courts.I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Signature Dated: Attorney License No. Law Firm Name: Address: City/State/Zip: Telephone: E-mail address: County and State where signed American LegalNet, Inc. www.FormsWorkFlow.com