ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY, DO NOT FILE OR LODGE IN CASE FILE Telephone No.: Fax No. (Optional) E-Mail Address (Optional) SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS Street Address: 800 11th Street, Modesto, CA 95354 Civil Clerk' Office: 1100 I Street, P.O. Box 1098, Modesto, CA 95353 Case No. APPLICATION FOR ELIGIBILITY FOR APPOINTMENT AS COUNSEL I, ____________________________________________, declare as follows: 1. I hereby seek eligibility for appointment as court appointed counsel in probate cases. I seek appointment as counsel for ____________________________________________________. (Please list type of proceeding for which appointment is sought.) 2. I certify that I meet the minimum standards for practice, education, and experience set forth in California Rules of Court, rule 7.1101, as demonstrated in the attached Certification of Attorney Concerning Qualifications for Court Appointment in Conservatorships or Guardianships (Judicial Council form GC-010). 3. I understand that if I am appointed as counsel in a probate matter, I will be required to certify to the court pursuant to California Rules of Court, rule 7.1101(h), that I have completed the continuing education requirements set forth in California Rules of Court, rule 7.1101(f). I further understand that time spent and/or costs incurred while engaging in continuing education to maintain eligibility for appointment as counsel is not chargeable time to the county or the court and shall not be reimbursed in a request for attorney fees or costs in any probate proceeding. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ___________________________ _____________________________________ (Signature of attorney) ________________________________________________________________________________ ORDER 1. The above-named attorney is deemed eligible for appointment as counsel in probate matters. 2. The above-named attorney is not deemed eligible for appointment as counsel in probate matters for the following reason(s):______________________________________________ ________________________________________________________________________________ Dated: _____________________ _____________________________________ Judge of the Superior Court APPLICATION FOR ELIGIBILITY FOR APPOINTMENT AS COUNSEL Adopted for Mandatory use Stanislaus County Local Form No. PR004 CRC 7.1101 August 2008 American LegalNet, Inc. www.FormsWorkflow.com