FOR COURT USE ONLY Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & Email Address Attorney for UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA _____________ DIVISION In re: CASE NO: CHAPTER: Debtor(s), Plaintiff(s), ADVERSARY NO.: APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE [LBR 2090-1(b)] vs. DATE: TIME: COURTROOM: PLACE: Defendant(s), 1. I, _________________________________________, hereby apply to the Court under LBR 2090-1(b) for permission to appear and participate in the above-entitled action on behalf of the following named party, by whom I have been retained (Specify Name of Party): 2. I have paid the required fee specified in LBR 2090-1(b)(5) to the United States District Court and have attached a copy of the receipt. 3. I am a lawyer with the following law firm (Specify Name and Address of Law Firm): 4. I am a member in good standing and eligible to practice before the following courts, and admitted to practice on the following dates (Specify Name of Jurisdiction and Date of Admission to Practice in such Jurisdiction): 5. I am not a resident of, nor am I regularly employed, engaged in business, professional or other activities in the state of California. I am not currently suspended or disbarred in any court. 6. I have concurrently or within the past 36 months made pro hac vice applications to this court in the following actions: Court Case Number Title of Action Date of Application Disposition of Application This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. April 2010 Page 1 F 2090-1.2.APPLICATION 7. I ‰ have ‰ have not details are as follows: I ‰ resigned been disciplined by any court or administrative body ‰ did not resign ‰ disciplinary proceedings are pending; while disciplinary proceedings were pending. 8. I certify that I have read the LBRs, the FRBP, the F.R.Civ.P., and the F.R.Evid., in their entirety. 9. I designate the following person of the following law firm who is a member of the bar of this court and maintains an office in this district for the practice of law, as the attorney with whom the court and opposing counsel may readily communicate regarding the conduct of this case, and upon whom papers may be served: Name of Attorney (Designee): Name and Address of Law Firm, or residence address: Telephone number of Law Firm: 10. I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Date: ______________________________________ Type Name of Applicant _______________________________________ Signature of Applicant CONSENT OF DESIGNEE I hereby consent to the foregoing designation. Date: ______________________________________ Type Name of Designee _______________________________________ Signature of Designee This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. April 2010 Page 2 F 2090-1.2.APPLICATION NOTE: When using this form to indicate service of a proposed order, DO NOT list any person or entity in Category I. Proposed orders do not generate an NEF because only orders that have been entered are placed on a CM/ECF docket. PROOF OF SERVICE OF DOCUMENT I am over the age of 18 and not a party to this bankruptcy case or adversary proceeding. My business address is: A true and correct copy of the foregoing document described as will be served or was served (a) on the judge in chambers in the form and manner required by LBR 5005-2(d), and (b) in the manner indicated below: I. TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (“NEF”) - Pursuant to controlling General Order(s) and LBR(s), the foregoing document will be served by the court via NEF and hyperlink to the document. On ________________________ I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following person(s) are on the Electronic Mail Notice List to receive NEF transmission at the email addressed indicated below: G Service information continued on attached page II. SERVED BY UNITED STATES MAIL OR OVERNIGHT MAIL (indicate method for each person or entity served): On _________________________ I served the following person(s) and/or entity(ies) at the last known address(es) in this bankruptcy case or adversary proceeding by placing a true and correct copy thereof in a sealed envelope in the United States mail, first class, postage prepaid, and/or with an overnight mail service addressed as follow. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed. G Service information continued on attached page III. SERVED BY PERSONAL DELIVERY, FACSIMILE TRANSMISSION OR EMAIL (indicate method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on _______________________ I served the following person(s) and/or entity(ies) by personal delivery, or (for those who consented in writing to such service method) by facsimile transmission and/or email as follows. Listing the judge here constitutes a declaration that mailing to the judge will be completed no later than 24 hours after the document is filed. G Service information continued on attached page I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. _________________________________________________________ Date Type Name _____________________________________ Signature This form is mandatory. It has been approved for use by the United States Bankruptcy Court for the Central District of California. April 2010 Page 3 F 2090-1.2.APPLICATION