UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF FLORIDA PETITION FOR ADMISSION TO THE BAR I. Attorney Information: _____________________________________________ Last Name First Name Middle Name Generation _____________________________ Bar Number & State of Issuance _____________________________________________ Firm Name _____________________________ Attorney E-Mail Address ______________________________________________________________________________ Firm Street Address City State Zip Code ______________________________________________________________________________ Firm Mailing Address (i.e. P.O. Box) City State Zip Code ________________________________ Office Phone Number II. ______________________________ Office Fax Number Completion of Tutorials (Please check appropriate item): Both tutorials are required by ND/FL L.R. 11.1(A). No waiver or exceptions will be allowed. _______ I have completed the following tutorials: On-line local rules tutorial Date tutorial completed: Confirmation Number: CM/ECF Tutorial Date tutorial completed: III. Bar Membership Credentials: I am admitted to practice before the following courts (attach separate list if needed): (A) (B) (C) (D) (E) _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ Date Admitted _______________________ Date Admitted _______________________ Date Admitted _______________________ Date Admitted _______________________ Date Admitted _______________________ American LegalNet, Inc. www.FormsWorkFlow.com IV. Request for Expedited Petition If there is cause for your petition to be processed within 1- 3 working days of receipt by the Clerk’s Office, please indicate below. (Petitions are normally processed within 5 working days.) Please expedite my petition. Reason: ______________________________________________________________ ____________________________________________________________________ V. Attachments to the Petition: a. Attach an original Certificate of Good Standing from The Florida Bar or the state bar in which you are a member. The Certificate of Good Standing should be dated within thirty (30) days of the date of the submitted petition. b. Attach the admission fee of $196.00 payable to “Clerk, U.S. District Court.” ($20.00 of this fee will be deposited into the Federal Bench and Bar Fund of the Court.) Any attorney representing the United States or the State of Florida, and who is an employee of the United States or the State of Florida, respectively, is exempt from paying the admission fee. Under penalty of perjury and subject to the provisions of the special rules governing the admission, I hereby apply for admission to practice in the United States District Court for the Northern District of Florida. ________________________________________ Signature _____________________________ Date Please return the completed application to: Clerk, U.S. District Court Attn: Attorney Admissions 111 N. Adams St., Suite 322 Tallahassee, FL 32301-7717 ***Once you receive your e-mail notice of admission to the Northern District of Florida bar, you should next register for a login for Electronic Case Filing (CM/ECF). Please refer to the CM/ECF tab on our web site at www.flnd.uscourts.gov. Your admission to the bar does not automatically enroll you for electronic case filing. An on-line request must be submitted separately.*** (Revised 11-1-11) American LegalNet, Inc. www.FormsWorkFlow.com