Rev. 1/201 U.S. DISTRICT AND BANKRUPTCY COURTS FOR THE DISTRICT OF COLUMBIA ATTORNEY RENEWAL/GOVERNMENT CERTIFICATION FORM PLEASE COMPLETE THE INFORMATION REQUESTED BELOW: Last Name: First Name: Middle Name: Generation (Jr.,Sr., etc.): Last four (4) digits of Social Security Number: Date of Birth: USDC Bar Number: USDC Date of Admission: Principal Office Address: Firm: Street: Suite: City: State: Zip: Phone: Unit (within firm or agency): E-Mail Address: STATE/FEDERAL GOVERNMENT ATTORNEY:Yes No NOTE: All occasions, if any, on which you have been held in contempt of Court, convicted of a crime, censured, suspended, disciplined or disbarred by any Court since your last renewal date should be noted on a separate sheet attached to this form. State the facts and circumstances connected therewith. CHANGE OF ADDRESS This form may serve as written notification to the Clerk's Office of address change under the requirements of Local Rule 83.15(c). However, this notification DOES NOT fulfill the PRAECIPE requirement of the Rule. 83.15(c) requires that, "(t)he attorney shall also within 10 days file a praecipe reflecting such change in each case which the attorney has pending before this Court serving a copy upon each of the attorneys in these cases." FAILURE TO RENEW An attorney who fails to file the required certification and pay the renewal fee will be provisionally removed from the list of members in good standing. The attorney will be restored to the list of members in good standing upon the filing of the required certificate and payment of the delinquent fee within five years after the due date. At the end of the five years from the due date, the attorney222s name will be permanently removed from the roll, without prejudice to an application for admission as a new member. [Local Rule 83.9(c)]. PLEASE REMEMBER: THERE IS A $25.00 RENEWAL FEE!! PAYABLE ONLINE VIA ECF AND PAY.GOV: IN CASE 1mc9999Visit for more information. -OR- PAYABLE BY CHECK TO: CLERK, U.S. DISTRICT COURT MAIL TO: U.S. DISTRICT AND BANKRUPTCY COURTS FOR THE DISTRICT OF COLUMBIA 333 Constitution Avenue, NW Room 1225 Washington, DC 20001 1 American LegalNet, Inc. www.FormsWorkFlow.com U.S. DISTRICT AND BANKRUPTCY COURTS FOR THE DISTRICT OF COLUMBIA ATTORNEY CERTIFICATION In compliance with Local Rule 83.9(a) AND LCrR 57.21.1, all attorneys who are members in good standing of the bar of this Court, AND/OR, government attorneys eligible to practice by virtue of LCvR 83.2(e) or (f)/LCrR 44.1(e), must submit this certification and hereby certify that he/she: (MANDATORY FOR ATTORNEYS WHO ARE MEMBERS OF THE BAR OF THIS COURT) (OPTIONAL FOR ATTORNEYS WHO WISH TO MAINTAIN A 'GOVERNMENT' STATUS) 1.is familiar with the current version of the Federal Rules of Civil Procedure, the Federal Rules of Evidence, theLocal Rules of this Court, the Rules of Professional Conduct as adopted by the District of Columbia Court ofAppeals, and the D.C. Bar Voluntary Standards for Civility in Professional Conduct, adopted by the Bar onJune 18, 1996; and/or 2.is familiar with the current version of the Federal Rules of Criminal Procedure, the Sentencing Guidelines, theFederal Rules of Evidence, the Local Rules of this Court, and the Code of Professional Conduct as adopted bythe District of Columbia Court of Appeals. (Attorneys who appear in criminal cases.) In compliance with Local Rule 83.2(b) or LCrR 44.1(b), an attorney who wishes to appear as sole or lead counsel in a contested evidentiary hearing or trial on the merits further certifies that he/she: (CHECK ALL ITEMS THAT APPLY) 3.has previously acted as sole or lead counsel in a federal district court or the Superior Court of the District ofColumbia or a state trial court of general jurisdiction in a contested jury or bench trial or other contestedevidentiary hearing in which testimony was taken in open court and an order or other appealable judgment wasentered. [LCvR 83.2(b)(1)/LCrR 44.1(b)(1)]; OR 4.has participated in a junior capacity in an entire contested jury or bench trial in a federal district court or theSuperior Court of the District of Columbia or a state trial court of general jurisdiction. [LCvR 83.2(b)(2)/LCrR44.1(b)(2)]; OR 5.has satisfactorily completed a continuing legal education trial advocacy course of at least 30 hours sponsoredby the District of Columbia Bar or accredited by a State Bar. [LCvR 83.2(b)(3)/LCrR 44.1(b)(3)] In consideration of LCvR 83.10(a) and 83.11, the undersigned applicant certifies that he/she: (OPTIONAL) 6.has read LCvR 83.10(a) and understands that members in good standing of the bar of this Court have anobligation to assist or represent the needy in civil matters before this Court whenever requested by the Courtand if necessary, without compensation. I have read LCvR 83.11 and understand that the Court has establisheda voluntary Civil Pro Bono Panel from which attorneys may be appointed by the Court to represent indigentpro se litigants. I have indicated below whether I would like to receive additional information regarding the Court's Civil Pro Bono Panel. Please Send Do Not Send I declare under penalty of perjury that the foregoing is true and correct. DATE SIGNATURE OF ATTORNEY (If electronically filed, use /s/ [Name of Attorney]) 2 American LegalNet, Inc. www.FormsWorkFlow.com