UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON OFFICE OF THE CLERK WILLIAM M. MCCOOL CLERK OF COURT UNITED STATES COURTHOUSE 700 STEWART STREET, SUITE 2310 SEATTLE, WASHINGTON 98101 PETITION FOR CONDITIONAL ADMISSION TO PRACTICE INSTRUCTIONS Complete and return the Petition for Conditional Admission to Practice. • Form is fillable using Adobe Acrobat Reader. • Form must be notarized. • Verification required by Western District of Washington Assistant U.S. Attorney Complete the registration form for the court’s Electronic Case Management (ECF) system. • Required for electronic filing privileges. Submit documents to the Clerk of Court. • Clerk, United States District Court Western District of Washington United States Courthouse Suite 2310 Attn: Attorney Admissions 700 Stewart Street Seattle, WA 98101 For questions, or to check the status of your petition, contact the attorney admission clerk. • Dana Scarp Phone: 206-370-8862 E-mail: dana_scarp@wawd.uscourts.gov American LegalNet, Inc. www.FormsWorkFlow.com CONDITIONAL ADMISSION UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON COMES NOW ___________________________________________, a member in good standing of the bar of (include bar number and state) ___________________________________, and respectfully petitions the Court, pursuant to Local General Rule (GR) 2(c)(2), for conditional admission to practice before the Bar of this Court as an employee of the United States representing one of its agencies. In support of said petition, Petitioner states as follows: 1. Petitioner’s residence address is: ______________________________________________________________________________ Petitioner’s home telephone is: ______________________________________ Petitioner is currently employed by the United States as an Attorney for (name of agency): ______________________________________________________________________________ Agency address: ______________________________________________________________________________ Agency telephone # (include extension): _____________________________________________ Agency e-mail address:___________________________________________________________ 2. Petitioner’s general and legal education are as follows: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com 3. From the time of Petitioner’s admission to the bar of ________________________ (as indicated above) on _________________ (date), Petitioner has been engaged in the practice of law at: _____________________________________________________________________________ . 4. Petitioner seeks conditional admission, pursuant to Local Rule GR 2(c)(2), as an attorney for the United States representing one of its agencies. The circumstances necessitating Petitioner’s conditional admission to the Bar of this Court are as follows: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. Verification that Petitioner is an attorney for the United States by an Assistant United States Attorney for this District is attached. 6. Petitioner certifies that he/she has read and is familiar with the Federal Rules of Civil and Criminal Procedure and the Local Rules of this Court. American LegalNet, Inc. www.FormsWorkFlow.com WHEREFORE, Petitioner herein respectfully petitions that he/she be conditionally admitted to practice before the Bar of the United States District Court for the Western District of Washington. OATH I solemnly swear that I will support and defend the Constitution and the laws of the United States of America against all enemies, foreign and domestic; that I will and faithfully discharge my duties as a lawyer, counselor, and proctor of this Court; and that I will maintain the respect due to the courts of justice and judicial officers and I will demean myself uprightly and accordingly to law and recognized standards of ethics of the legal profession, SO HELP ME GOD. STATE OF ___________________________ ) ) COUNTY OF _________________________ ss ) ____________________________________________, Petitioner herein, being first duly sworn, on oath deposes and says: That he/she has read the foregoing petition and that the facts stated therein are true of Petitioner’s own knowledge. ________________________________________________ Petitioner’s Signature SUBSCRIBED and SWORN to before me this ________ day of________________, ________________________________________________ Notary Public in and for the State of __________________, (Notary Seal) residing at ______________________________________. My appointment expires ___________________________ . American LegalNet, Inc. www.FormsWorkFlow.com VERIFICATION OF ASSISTANT UNITED STATES ATTORNEY I, ______________________________________________, hereby verify that I am an Assistant United States Attorney for the Western District of Washington. I verify that ___________________________________________ is an Attorney for the United States. DATED at ________________, Washington this ______ day of ____________, 2____. __________________________________________ Signature __________________________________________ Print or Type Name Assistant United States Attorney American LegalNet, Inc. www.FormsWorkFlow.com REGISTRATION FORM for the ELECTRONIC CASE FILING SYSTEM Last Name: Middle: First: PRO SE APPLICANTS ONLY: Please enter your case number below so we can activate you to electronically file in your case. You do not need to fill out Attorney Bar #, State, or Firm Name. Attorney Bar # and State: Firm Name: Street Address 1: Address Line 2: State: City: Telephone Number: Internet E-mail Address: Zip: Case #: (PRO SE APPLICANTS ONLY) Back-up E-mail Address: Does your e-mail software support HTML messages? Yes No By submitting this registration form, the undersigned understands and agrees to the following: 1. The CM/ECF system is to be used for filing and reviewing electronic documents, docket sheets, and notices. 2. The password issued to you by the court, combined with your login, serves as your signature under Federal Rule of Civil Procedure 11. Therefore, you are responsible for protecting and securing this password against unauthorized use. 3. If you have any reason to suspect that your password has been compromised in any way, you are responsible for immediately notifying the court. Members of the court's systems staff will assess the risk and advise you accordingly. 4. By signing this Registration Form, you consent to receive notice electronically, and to waive your right to receive notice by personal service or first class mail pursuant to Federal Rule of Civil Procedure 5(b)(2)(C), except with regard to service of a complaint and summons. This provision does include electronic notice of the entry of an order or judgment. 5. You will continue to access court information via the Western District of Washington's internet site or through the Public Acess to Court Electronic Records (PACER) system. You will continue to need a PACER login, in addition to the court-issued password. You can register for PACER at their web site: http://pacer.psc.uscourts.gov 6. By this registration, the undersigned agrees to abide by the rules and regulations in the most recent General Order, the Electronic Filing Procedures developed by the Clerk's Office, and any changes or additions that may be made to such administrative procedures in the future. Signature (either sign or use an "s/" and type your name) Date Signed American LegalNet, Inc. www.FormsWorkFlow.com