NOTICE TO: FR: RE: Attorneys Peter J. Welsh, Acting Clerk of Court Special or General Admission Attached is a petition for Admission to Practice in this Court. SPECIAL ADMISSION: If you are seeking special admission for a particular case, you need to complete the attached petition. If you are an ECF registered user, please fill out the form and file your Petition for Special Admission electronically through the Court's ECF System.To file your petition, log into ECF, click on civil or criminal, then click on "Other Documents" and select the "Petition for Special Admission - Pro Hac Vice" event. During the filing of your petition, you will be prompted to enter your credit card information for the $50.00 fee associated with this filing. If you are not an ECF registered user, you are urged to register for ECF as soon as possible. You can obtain an ECF registration form from the court's web site at www.pamd.uscourts.gov. If you will be filing a Request for Waiver from Filing Electronically or have been granted a waiver, you may file your Special Admission request at one of the offices located in the Federal Buildings in Scranton, Harrisburg and Williamsport, PA. Please be sure to send a check in the amount of $50.00, made payable to the Clerk, U.S. District Court, with your petition. The basis for your admission is the case you are handling and you should list the case name and number in the appropriate spot. GENERAL ADMISSION: If you are seeking general admission in Scranton or Williamsport, please complete the attached petition, contact one of the judges in either city, and set up a time to appear before the court to be sworn in. For information regarding general admission in Harrisburg, please contact the Clerk's office there, at 717-221-3920, to make arrangements. On the day you are sworn in, your sponsor must be present to move for your admission. Bring the completed application with you, together with a check for $206.00, payable to Clerk of Court. If you need any further assistance, feel free to call my office at (570) 207-5600. American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF PENNSYLVANIA IN THE MATTER OF APPLICATION FOR : ADMISSION TO PRACTICE IN THIS COURT : PETITION I _________________________________, hereby petition the United States District Court for the Middle District of Pennsylvania to admit me to practice before that Court. In support of my petition, I state as follows: My office address is: __________________________________________ __________________________________________ __________________________________________ Office Telephone: __________________________________________ I was admitted to practice before the Courts listed below on the date shown after the name of each Court, and I am currently a member in good standing of all those Courts. My attorney Identification number is: ___________________ FOR COURT USE ONLY _____ GENERAL ADMISSION: GRANTED BY THE COURT: ______________________ _____ SPECIAL ADMISSION: GRANTED BY THE COURT _______________________ Date: _____________ Date: _____________ American LegalNet, Inc. www.FormsWorkFlow.com Please Answer the Following Questions: All occasions, if any, on which I have been convicted of a crime (subsequent to my becoming an attorney), censured, suspended, disciplined or disbarred by any court are set forth as follows: (State the facts and circumstances connected with each; if none, state "none".) All occasions, if any, on which I have been held in contempt of court are set forth as follows: (State the nature and final disposition of contempt; if none, state "none".) I do _____, do not _____, have any disciplinary action, contempt or other proceedings involving me pending before any court. (Check the appropriate space.) If there are pending proceedings, please explain: I am seeking: General Admission under Local Rule LR 83.8.1 Special Admission (specify by a check which rule) under LR 83.8.2.1 , LR 83.8.2.2 , LR 83.8.2.3 , or LR 83.8.2.4 If seeking special admission under Local Rules LR 83.8.2.1, LR 83.8.2.2, LR 83.8.2.3, or LR 83.8.2.4, the basis for my admission under the designated rule is as follows: NAME THE PARTY YOU REPRESENT: If special admission is requested for a particular case, please list case number and caption: Case # Caption # American LegalNet, Inc. www.FormsWorkFlow.com I understand that: 1) If seeking admission under Section LR 83.8.2.2, LR 83.8.2.3, or 83.8.2.4, I must submit a letter from a superior stating the agency with which I am employed and the duties performed which qualify me for admission under those sections. If petitioning for admission, only in a particular case, under Rule LR 83.8.2.1, I need no sponsor's certificate. Any attorney specially admitted under LR 83.8.2.1, shall, in each proceeding in which he or she appears, have associate counsel who is generally admitted under Local Rule 83.8.1 to practice in this court, whose appearance shall also be entered of record and upon whom all pleadings, motions, notices, and other papers may be served in accordance with any statute or applicable rule. The attendance of any such associate counsel upon the hearing of any motion or the taking of any testimony shall be sufficient appearance for the party or parties represented by such associate counsel. Either the specially admitted attorney or associate counsel must be fully prepared to participate in any hearings, arguments, conferences and trials. (See LR 83.9) If special admission is requested for a particular case, please list the name, address, telephone number and bar identification number of associate counsel to be entered of record in the case: 2) 3) If seeking general admission under Rule LR 83.8.1, I must be a member of the bar of the Supreme Court of Pennsylvania and have a sponsor who is a member in good standing of the Bar of this Court present to move for my admission and I must submit the sponsor's certificate with my petition. PETITIONER (Bar Identification Number and State where admitted) (Date) By signing this petition for admission, I acknowledge that I have read the attached Middle District of Pennsylvania Code of Professional Conduct and agree to subscribe to the standards set forth in the Code. NAME OF PETITIONER American LegalNet, Inc. www.FormsWorkFlow.com SPONSOR'S CERTIFICATE: I, ________________________________________, am a member in good standing of the Bar of the United States District Court for the Middle Distric