This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. June 2016 Page 1 F 2090-1.2.APP.NONRES.ATTY Attorney or Party Name, Address, Telephone & FAX Nos., State Bar No. & Email Address FOR COURT USE ONLY Attorney for: UNITED STATES BANKRUPTCY COURT CENTRAL DISTRICT OF CALIFORNIA - DIVISION In re: Debtor(s).CASE NO.: ADVERSARY NO.: CHAPTER: APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE [LBR 2090-1(b)] Plaintiff(s). vs. Defendant(s). [No hearing required per LBR 2090-1(b)(6)] 1.I,, apply to the court under LBR 2090-1(b) for permission to appear and participate in the above-entitled action on behalf of thefollowing 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 acopy of the receipt.This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. June 2016 Page 2 F 2090-1.2.APP.NONRES.ATTY 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 thefollowing dates (specify name of each such jurisdiction and my date of admission to practice in each such jurisdiction): 5.I am not a resident of, nor am I regularly employed, engaged in business, professional or other activities in the state ofCalifornia. 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: 7.I have have not been disciplined by any court or administrative body disciplinary proceedings are pending; details are as follows: I resigned did not resign 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 anoffice in this district for the practice of law, as the attorney with whom the court and opposing counsel may readilycommunicate 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: Court Case Number Title of Action Date of Application Disposition of Application This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. June 2016 Page 3 F 2090-1.2.APP.NONRES.ATTY 10.I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date: Signature of applicant Printed name of applicant CONSENT OF DESIGNEE I consent to the foregoing designation. Date: Signature of Designee Printed name of Designee This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. June 2016 Page 4 F 2090-1.2.APP.NONRES.ATTY 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 entitled: APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE [LBR 2090-1(b)] 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 stated below: 1.TO BE SERVED BY THE COURT VIA NOTICE OF ELECTRONIC FILING (NEF): Pursuant to controlling General Orders and LBR, the foregoing document will be served by the court via NEF and hyperlink to the document. On (date) , I checked the CM/ECF docket for this bankruptcy case or adversary proceeding and determined that the following persons are on the Electronic Mail Notice List to receive NEF transmission at the email addresses stated below: Service information continued on attached page 2.SERVED BY UNITED STATES MAIL: On (date) , I served the following persons and/or entities at the last known addresses 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 addressed as follows. Listing the judge here constitutes a declaration that mailing to thejudge will be completed no later than 24 hours after the document is filed. Service information continued on attached page 3.SERVED BY PERSONAL DELIVERY, OVERNIGHT MAIL, FACSIMILE TRANSMISSION OR EMAIL (state method for each person or entity served): Pursuant to F.R.Civ.P. 5 and/or controlling LBR, on (date) , I served the following persons and/or entities by personal delivery, overnight mail service, or (for those who consented in writing tosuch service method), by facsimile transmission and/or email as follows. Listing the judge here constitutes a declarationthat personal delivery on, or overnight mail to, the judge will be completed no later than 24 hours after the document is filed. Service information continued on attached page I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct. Date Printed Name Signature This form is mandatory. It has been approved for use in the United States Bankruptcy Court for the Central District of California. June 2016 Page 5 F 2090-1.2.APP.NONRES.ATTY