United States Court of Appeals for the Ninth Circuit P.O. Box 193939 San Francisco, CA 94119-3939 APPLICATION AND OATH FOR ADMISSION PERSONAL INFORMATION Name (Last, First, Middle): Social Security # Date of Birth Firm Name or Agency Mailing Address (no P.O. Box) Phone City Fax BAR INFORMATION Federal/State Admissions (max. 2) State Zip Email Status (Active/Inactive) Bar Number Date Admitted (mm/dd/yy) Answer each question. If any answer is yes, attach a statement providing details. Yes No 1. Have you been known by any name other than that appearing on the application? 2. Have you ever been disbarred or suspended from practice before any court or government agency? 3. Are any such actions pending against you? 4. Are you currently under investigation by, or have you ever received a reprimand from any court or government agency? OATH I, , certify under penalty of perjury under the laws of the United States of America (Name as you want it to appear on your certificate) that the foregoing is true and correct. I do solemnly swear [or affirm] that I will conduct myself as an attorney and counselor of this Court, uprightly and according to law; and that I will support the Constitution of the United States. Signature of Applicant Date MOTION FOR ADMISSION This section must be completed by a sponsor in good standing with the Ninth Circuit Court of Appeals. , a member in good standing of the Bar of the United States Court of Appeals (Full name of sponsor) for the Ninth Circuit, hereby move the admission of to the Bar of this Court. I am satisfied that the applicant possesses the qualifications set forth by Federal Rule of Appellate Procedure 46(a). I, Signature of Sponsor Date Firm Name or Agency Phone Street Address City State Zip Submit your application and admission fee in one of two ways: 1. If you are registered for Appellate ECF, upload your application via ECF and pay with a credit card by logging in to Appellate ECF and choosing Utilities > Attorney Admission. Step-by-step instructions are available in the ECF User Guide at http://www.ca9.uscourts.gov/datastore/uploads/cmecf/ecf-user-guide.pdf Note: To secure your input and upload this form into Appellate ECF, print the filled-in form to PDF (File > Print > PDF Printer/Creator). 2. Mail the completed application to the Court along with your check for $200.00 payable to Clerk, U.S. Court of Appeals. rev. July 2011 American LegalNet, Inc. www.FormsWorkFlow.com