FRESNO COUNTY SUPERIOR COURT ATTORNEY APPLICATION FOR APPOINTMENT TO PROBATE REFERENCE PANEL I, _____________________, apply for appointment to the Probate Reference Panel. 1. ________. I was admitted to practice law in the State of California in (year) 2. I agree to comply with the terms of the eligibility requirements, including but not limited to the following. a. I have read the eligibility requirements for panel members, and I meet those requirements. b. I acknowledge ethical conflict of interests rules apply. I will review my position with respect to each particular appointment. I agree to advise the parties immediately if a conflict exists or arises. c. I have read and agree to comply with all applicable sections of Fresno Superior Court Local Rules, Probate Policy Memorandum. 3. I speak the following foreign languages: ________________________ 4. I have been subject to a State Bar disciplinary proceeding: Yes: _____ No: _____ If you answered “Yes,” please explain: ______________________________ ___________________________________________________________________ 5. If at any time while I am a member of this panel my status as a member of the State Bar changes, I agree to notify the Court, in writing within 10 days of that change. American LegalNet, Inc. www.USCourtForms.com FRESNO COUNTY SUPERIOR COURT 6. I do not wish to serve as temporary judge in these types of matters: _____conservatorships and guardianships _____probate administration _____trust administration _____selection of fiduciaries _____surcharge actions _____accounting disputes I declare under penalty of perjury, under the laws of the State of California, that the foregoing is true and correct. Dated: _____________ Signed: ___________________________ Name: __________________________________________________ Address: __________________________________________________ __________________________________________________ _____________________________ _____________________________ Telephone: Facsimile: Effective January 1, 2005 American LegalNet, Inc. www.USCourtForms.com