UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF CALIFORNIA In re Debtor(s). The following additional information is required when filing this form in an adversary proceeding. Adversary Proceeding No. v. Plaintiff(s), Defendant(s). Bankruptcy Case No. APPLICATION FOR ADMISSION TO PRACTICE PRO HAC VICE 1. Pursuant to Local Rule 1001-1(c) of the United States Bankruptcy Court for the Eastern District of California and Local Rule 180(b)(2) of the United States District Court for the Eastern District of [applicant's name] hereby California, I, apply for admission to practice pro hac vice, to appear and participate in this case/proceeding as counsel [name(s) of for party(ies) represented]. 2. In support of this application, I state under penalty of perjury that: a. I reside in : b. My business address is: Firm Name: Address: City: State: Voice Phone: ( [city and state]. ) ZIP Code: State Bar Membership #: c. I have been admitted to practice by the following Court(s) [List all of the courts the applicant has been admitted to practice before. Attach additional pages if necessary.]: Court Admission Date Court Admission Date EDC 2-600 (Rev. 11/1/11) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com d. I am a member in good standing of, and eligible to practice before, the Bar in said Courts. A copy of a certificate of good standing from the Court in the state of my primary practice is attached. I am not currently suspended or disbarred in any Court. e. I [check one] G have G have not concurrently or within the year preceding this application made other pro hac vice applications to this Court. The cases/proceedings, if any, in which pro hac vice application was made concurrently or within the year immediately preceding the filing of this application are listed below. [Attach additional pages if necessary.] Case No. Case Title Application Date Granted or Denied? f. The $200.00 fee prescribed for filing an application for admission to practice pro hac vice has been paid to the Clerk, U.S. District Court, Eastern District of California ( U.S. District Court receipt number ). [NOTE: U.S. District Court receipt number indicating payment is REQUIRED. Applications submitted without a valid U.S. District Court receipt number will NOT be processed.] 3. I hereby designate the following member in good standing of the Bar of this Court, and an authorized user of this Court's electronic filing system, as local counsel with whom the Court and opposing counsel may readily communicate in this matter regarding conduct of the action and upon whom service shall be made. Said designee consents to this designation by signing below. Name: Address: City: State: Voice Phone: ( Date: Applicant's Signature Date: Designee's Signature NOTE: This completed application, any continuation pages, and a copy of applicant's certificate of good standing shall be electronically filed with the bankruptcy court by designated local counsel, together with Form EDC 2- 601, Order Concerning Admission to Practice Pro Hac Vice, completed in all respects except for checking a box and inserting the date. For additional information, see form EDC 2-600-INST, Instructions Regarding Application for Admission to Practice Pro Hac Vice. EDC 2-600 (Rev. 11/1/11) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com ) ZIP Code: CA Bar ID #: