Name and address: UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA CASE NUMBER v. Plaintiff(s) Defendant(s). (PROPOSED) ORDER ON APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE PRO HAC VICE The Court, having determined whether the required fee has been paid, and having reviewed the Application of Non-Resident Attorney to Appear in a Specific Case Pro Hac Vice filed by of Applicant's Name (Last Name, First Name & Middle Initial) Telephone Number Fax Number E-Mail Address Firm/Agency Name & Address for permission to appear and participate in this case on behalf of Name(s) of Party(ies) Represented Plaintiff(s) Defendant(s) Other: and designating as Local Counsel of Designee's Name (Last Name, First Name & Middle Initial) Designee's Cal. Bar No. Telephone Number Fax Number E-Mail Address Firm/Agency Name & Address HEREBY ORDERS THAT the Application be: GRANTED. for failure to pay the required fee. DENIED: for failure to attach a Certificate of Good Standing issued within 30 days prior to filing of Application. for failure to complete Application: pursuant to L.R. 83-2.1.3.2: Applicant resides in California; previous Applications listed indicate Applicant is regularly employed or engaged in business, professional, or other similar activities in California. does not maintain office in District. is not member of Bar of this Court; pursuant to L.R. 83-2.1.3.4; Local Counsel: because IT IS HEREBY FURTHER ORDERED THAT the Application fee, if paid: Dated G­64 ORDER (5/16) be refunded not be refunded. U.S. District Judge/U.S. Magistrate Judge (PROPOSED) ORDER ON APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE PRO HAC VICE American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 1