FORM 10-1 FORM 10 UNITED STATES COURT OF INTERNATIONAL TRADE Office of the Clerk Admissions Office - Room 299 One Federal Plaza, New York, NY 10278-0001 Telephone: 212-264-2812 APPLICATION FOR ADMISSION TO PRACTICE PART I - COMPLETED BY APPLICANT I, _______________________________________________, hereby apply for admission to practice before the United States Court of International Trade and make the following statements: 1. My contact information is: Affiliation/Firm: _________________________________________________________________ Title (if any): _________________________________ Firm Telephone: ____________________ Address: ____________________________________________ Suite/Floor: _________________ City: _________________________________ State: _____________ Zip: ___________________ County: __________________________ E-Mail: _______________________________________ Direct Telephone: __________________________ Fax:__________________________________ 2. I hereby certify that I meet the qualifications of CIT Rule 74(a) to practice before the United States Court of International Trade based on my admission and membership in good standing in the court listed below: Title of Court Date of Admission ____________________________ ____________________________ Have you ever been censured, disbarred or suspended from practice before any court? (Check the applicable answer). No  Yes  (If you answer yes, check the applicable answer to the following questions, and attach a separate statement explaining the nature of such actions or proceedings): Are there any disciplinary proceedings presently pending against you? Yes  No  I did  did not  resign while disciplinary proceedings were pending. I verify that I am attaching a separate statement explaining the nature of the proceedings.  3.  For all attorneys other than attorneys employed by the U.S. government: I have enclosed my $76 admission fee.  I have not enclosed an admission fee because I am an attorney employed by the U.S. government entitled to waiver of the fee under USCIT Rule 74(b)(3). I understand I will not receive a Certificate of Admission.  Although I am entitled to waiver of the fee as an attorney employed by the U.S. government, I request a Certificate of Admission and have included my $76 certificate fee. American LegalNet, Inc. www.FormsWorkFlow.com FORM 10-2 4. If this application is not submitted on oral motion, or if submitted on oral motion and the sponsoring attorney making the motion has not known me for more than one year, I enclose a certificate stating that I am a member in good standing of the court identified in part 2 above issued by a judge of or the clerk of that court, or by another official duly authorized to issue such certificates.  (Check, if applicable) A “certificate of good standing,” dated not more than ninety (90) days prior to this application, is attached. 5. I, _____________________________________, do solemnly swear (or affirm) that I will faithfully conduct myself as an attorney and counselor-at-law of this Court, uprightly and according to law, and that I will support the Constitution of the United States, so help me God. I have read and am familiar with the Rules of the United States Court of International Trade. I declare under the penalty of perjury that the foregoing is true and correct. Date: ____________________ Signature of Applicant: ________________________________ or, if signed outside the United States of America, I declare under the penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Date: ____________________ Signature of Applicant: ________________________________ PART II - COMPLETED BY SPONSORING ATTORNEY (if applicable) I, ____________________________________(insert name of sponsoring attorney), a member of the bar of this Court or of the Supreme Court of the United States, move the admission to practice before this Court of _________________________________(insert name of applicant). I have known the applicant since ____________________(insert approximate month and year) and consider the applicant to be a person of good moral character and in every way qualified to practice as a member of the Bar of this Court. I have read the application for admission, and, to the best of my knowledge and belief, the statements therein are true. __________________________________ Signature of Sponsoring Attorney ___________________________________________________ Address PART III - COMPLETED BY JUDGE Application for Admission approved on (date) ______________________________________, at (place) ________________________________________________. Signature of Judge: ___________________________________________ (As amended Jan. 1, 1996, eff. Jan. 1, 1996; March 25, 1998, eff. July 1, 1998; Sept. 30, 2003, eff. Jan. 1, 2004; Nov. 28, 2006, eff. Jan. 1, 2007; Nov. 25, 2008, eff. Jan. 1, 2009; March 24, 2009, eff. May 1, 2009; Nov. 25, 2009, eff. Jan. 1, 2010; March 27, 2012, eff. May 1, 2012.) American LegalNet, Inc. www.FormsWorkFlow.com