Office of the Clerk of Court UNITED STATES DISTRICT COURT Northern District of California United States Courthouse 450 Golden Gate Avenue San Francisco, California 94102 _____________ Internet: http://cand.uscourts.gov/ R ICHARD W . WIEKING Phone: 415.522.4633 Clerk REQUEST FOR CERTIFICATE OF GOOD STANDING INSTRUCTIONS: Complete and mail or deliver this form to: Clerk, U.S. District Court, Northern District of California, 450 Golden Gate Avenue, San Francisco, CA 94102, Attention: Attorney Admissions. Please enclose a self-addressed, stamped return envelope and a check for $15.00 made payable to “Clerk, U.S. District Court.” Certificates of Good Standing are completed in the order in which they are received and will be mailed to you as soon as possible. Date: Name as listed on Attorney Admission Petition: California State Bar #: Other Names Used: Approximate Date Admitted to the Bar of the Northern District of California: CA State Bar No: Mailing Address: Phone Number: American LegalNet, Inc. www.FormsWorkflow.com