UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF FLORIDA www.flsb.uscourts.gov In re Case No: Chapter Debtor / MOTION TO APPEAR PRO HAC VICE [Attorney's Name] of the firm of [Name of Firm], pursuant to Local Rules 2090-1(B)(2) and 9013-1(C)(9), moves for special admission to appear in this [case] [adversary proceeding] as counsel for [Name of Party] and states as follows: 1. Movant is an attorney licensed to practice law in the State of and has been a member in good standing of the Bar since . 2. Movant is also admitted to practice before [Names of United States Bankruptcy Courts, District Court and Courts of Appeal in which Movant is admitted to practice]. 3. Movant designates [Name of Local Attorney] who is qualified to practice in this court and who consents to designation as local counsel. [or Movant requests waiver of local counsel designation requirement for the following reason:] 4. Movant certifies that [he][she] has never been disbarred and is not currently suspended from the practice of law in the State of Florida or any other state nor from any United States Bankruptcy Court, District Court or Court of Appeals. 5. Movant certifies further that [he][she] is familiar with and shall be governed by the local rules of this court, the rules of professional conduct and all other requirements governing the professional behavior of members of the Florida Bar. LF-44 (rev. 06/02/08) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com WHEREFORE, Movant respectfully requests entry of the attached proposed order [attach completed local form "Order Admitting Attorney Pro Hac Vice" authorizing [his][her] special admission to practice in this [case] [adversary proceeding]. Dated: [Movant's Name Name of Firm Address Telephone Number Facsimile Number] BY: [Movant's Signature] CONSENT TO ACT AS LOCAL COUNSEL I, [Name of Local Attorney], an attorney qualified to practice in this court, consent to designation as local attorney for [Name of Movant] and agree to serve as designee with whom the court and opposing counsel may readily communicate regarding the conduct of this case, and upon whom papers shall be served in accordance with Local Rule 2090-1(B)(2). [Name of Local Attorney Florida Bar Number Firm Address Telephone Number Facsimile Number] BY: [Signature] COPIES TO: Debtor's Counsel Trustee [if appointed] U.S. trustee LF-44 (rev. 06/02/08) Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com