UNITED STATES COURT OF APPEALS DISTRICT OF COLUMBIA CIRCUIT 333 Constitution Avenue, NW Washington, DC 20001-2866 Phone: 202-216-7000 | Facsimile: 202-219-8530 FOR COURT USE ONLY FEE RCVD: ___________ Receipt No.: ___________ Receipt Date: __________ FEE WAIVED: __________ NO FEE RCVD: _________ APPLICATION FOR ADMISSION TO PRACTICE MOTION FOR ADMISSION MAY IT PLEASE THE COURT: I move the admission of whose application is based upon a certificate of admission and good standing to practice before the Bar of , (State name of court contained on attached certificate of admission and good standing) (Certificate will reflect name as shown here) , Having examined the credentials submitted, I vouch for the applicant, who in my opinion possesses the qualifications prescribed by the Federal Rules of Appellate Procedure and by the Circuit Rules of this Court. (Typed or printed name of Movant) (Signature of Movant) A member of the Bar of the United States Court of Appeals for the District of Columbia Circuit ORDER It is hereby ORDERED that the foregoing motion for admission is granted. ______________________________ Clerk NOTE: APPLICATION WILL NOT BE PROCESSED UNLESS ALL REQUIRED SIGNATURES ARE PRESENT AND ALL QUESTIONS ARE ANSWERED COMPLETELY. USCA Form 81 Rev. Dec. 2016 American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES COURT OF APPEALS DISTRICT OF COLUMBIA CIRCUIT 1. Name (First) (Middle) (Last) 2. Prefix (Mr., Mrs., Ms., etc.) 3. Place of Birth 4. DOB 5. Name of Parents: (a) Mother's maiden name (b) Father's name 6. Applicant's residence address. (City) (Street) (State) (Zip) 7. Office address (including street and number and name of law firm or organization) of applicant: Firm Name: Address: (Phone) (Phone) (FAX) (E-Mail) 8. List all law schools which you have attended, setting forth whatever degree(s) received and date(s) of receipt. 9. List all Bar examinations that you have taken, give the approximate date of each such examination, and indicate those on which you received a passing grade. 10. Give the DATE of admission and your BAR NUMBER for the courts listed below to which you have been admitted.Write "NOT ADMITTED'' where appropriate. Indicate whether admission was based upon examination motion or diploma privilege. (a) Supreme Court of the United States (b) US Court of Appeals for the (c) US District Court for the Circuit District of (date) (date) (bar #) (bar #) (d) Highest Court(s) of the State(s) (Territory) of (e) District of Columbia Court of Appeals USCA Form 81 Rev. Dec. 2016 (date) (bar #) (date) (date) (bar #) (bar #) American LegalNet, Inc. www.FormsWorkFlow.com 11. Citizenship (set forth name of country) 12. If a naturalized citizen of the United States, state, date and court in which naturalization proceedings took place. 13. Have you been suspended or disbarred from practice anywhere, or have you been censured or given any reprimand pertaining to your conduct or fitness as a member of the Bar? Yes No If yes, explain in full. Use separate sheet if necessary. 14. Has your right to practice before any federal, state or municipal department, bureau, commission, office or Yes No agency of any kind ever been qualified, terminated or withdrawn? If yes, explain in full. Use separate sheet if necessary. 15. (a) Have you been a defendant in any criminal proceeding in which allegations of fraud, misrepresentation or other dishonesty were made against you? If yes, explain in full and attach hereto copies Yes No of all court documents relative to the disposition of such proceedings. Use separate sheet if necessary. (b) Have you been convicted of a criminal charge other than a motor vehicle or traffic violation for which Yes No collateral could be forfeited? If yes, explain in full and attach hereto copies of all court documents relative to your charge and conviction. Use separate sheet if necessary. (c) Have you been a defendant in any civil proceedings, including bankruptcy proceedings, in which allegations of fraud, misrepresentation or other dishonesty were made against you? Yes No If yes, explain in full and attach hereto copies of all court documents relative to the disposition of such proceedings. Use separate sheet if necessary. USCA Form 81 Rev. Dec. 2016 American LegalNet, Inc. www.FormsWorkFlow.com OATH OR AFFIRMATION 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. I, do hereby subscribe to the foregoing oath (or affirmation) and say that I am the person named in the foregoing application and that the statements therein set forth are true and correct to the best of my knowledge and belief. (Signature of Applicant) Subscribed and sworn (affirmed) before me this (Notary Seal) day of , (Signature of Notary or Other Officer Authorized to Take Oaths and Affirmations) Title NOTE: THE FOLLOWING SHALL BE COMPLETED AFTER THE FOREGOING OATH OR AFFIRMATION HAS BEEN EXECUTED BY APPLICANT. The following statements are to be completed by applicant's sponsors. They must be either members of the Bar of this Court or of the Court upon which applicant bases his or her admission. Strike words and phrases within parentheses as appropriate. A sponsor who is a member of the Bar of this Court may also move the admission of the applicant by completing and signing the motion on page 1 of this application. I, , a member of (the Bar of this Court)(the Bar of ) have examined the executed personal statement of the applicant who is personally known to me. (He)(She) possesses all the qualifications required for admission to the Bar of this Court and I affirm that (his) (her) personal and professional character and standing are good. _________________ SIGNATURE OF FIRST SPONSOR DATE I, , a member of (the Bar of this Court) (the Bar of ) have examined the executed personal statement of the applicant who is personally known to me. (He) (She) possesses all the qualifications required for admission to the Bar of this Court andI affirm that (his) (her) personal and professional character and standing are good. _________________ SIGNATURE OF SECOND SPONSOR DATE American LegalNet, Inc. www.FormsWorkFlow.com USCA Form 81 Rev. Dec. 2016 EXCERPTS FROM RULE 46, CIRCUIT RULES OF THE UNITED STATES COURT OF APPEALS FOR THE DISTRICT OF COLUMBIA CIRCUIT RULE 46. Attorneys; Appearance by Law Student (a) Appearances. Except as otherwise provided by law, th