UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK 225 CADMAN PLAZA EAST 100 FEDERAL PLAZA BROOKLYN, NY 11201 CENTRAL ISLIP, NY 11722 (718) 613-2285 (631) 712-6030 REQUEST FOR CERTIFICATE OF GOOD STANDING The fee for a Certificate of Good Standing is $19.00. ATTORNEY INFORMATION Full Name State Bar Registration No. Firm/Company Name Address City State ZIP Phone () - Email Date of Admission in the Eastern District of New York Admitted in Signature of Attorney DIRECTIONS Return the completed request form and the $19.00 fee in the form of a check made payable to the Clerk of Court for the Eastern District of New York, (1) By mail, with a self-addressed, stamped envelope to the Court at either address noted above; or (2) In person, by the attorney or the attorney222s designee, to the Clerk222s Office at either courthouse noted above. American LegalNet, Inc. www.FormsWorkFlow.com