UNITED STATES BANKRUPTCY COURT NORTHERN DISTRICT OF GEORGIA 1340 U.S. COURTHOUSE 75 SPRING STREET, SW ATLANTA, GA 30303 (404) 215-1000 INSTRUCTIONS FOR ADMISSION PRO HAC VICE LOCAL RULE 9010-2, stated below, sets forth the requirements for admission pro hac vice: 9010-2. Permission to practice in a particular case. A non-resident attorney who is not an active member in good standing of the State Bar of Georgia, but who is a member in good standing of the bar of any United States Court or the highest court of any State may apply in writing for permission to appear pro hac vice. (a) Applications for admission pro hac vice may be obtained from the Bankruptcy Clerk. The applicant shall state under penalty of perjury the applicant’s (1) residence address, (2) office address and telephone number, (3) the courts to which admitted to practice and the date of admission, and (4) a statement that the applicant is in good standing and eligible to practice in all courts to which admitted. An attorney applying to appear pro hac vice must also designate a local member of the bar of this Court with whom the opposing counsel and the Court may readily communicate regarding the conduct of the case and upon whom papers shall be served. The address, telephone number, and written consent of the designated local counsel must be filed with the attorney's pro hac vice application. Applications for admission pro hac vice shall be accompanied by the appropriate filing fee and a proposed order to be signed by the Bankruptcy Judge and shall be presented to the Bankruptcy Clerk. The nonresident attorney may be permitted to appear pro hac vice in the discretion of the Bankruptcy Court. (b) If the non-resident attorney fails to respond to any order of the Court for appearance or otherwise, the designated local attorney shall have the responsibility and full authority to act for and on behalf of the client in all proceedings in connection with the case, including hearings, pretrial conferences, and trial. ADMISSION FEE: The fee for admission pro hac vice is $150.00 which must be paid in cash or by cashier’s check or money order, payable to the CLERK, U.S. DISTRICT COURT, ROOM 2211, 75 SPRING STREET, SW, ATLANTA, GA 30303. INSTRUCTIONS FOR COMPLETING THE APPLICATION: The application for Admission Pro Hac Vice must be typed and all blank spaces in the application must be completed. Information is subject to verification by Court personnel. The attorney designated as local counsel must be an active member in good standing with the State Bar of Georgia and a member in good standing with the Bar of this Court. The attorney must also provide his/her State Bar of Georgia membership number as indicated on the application. F69 (prohac vce) Revised 12/08 American LegalNet, Inc. www.FormsWorkflow.com page 1 of 4 IN THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF GEORGIA IN RE: ____________________________ BANKRUPTCY CASE NO.:____________________ ____________________________ Debtor(s) ADVERSARY NO.: ____________________ ____________________________ Plaintiff v. ____________________________ Defendant APPLICATION FOR ADMISSION PRO HAC VICE Petitioner, _______________________________, hereby requests permission to appear pro hac vice on behalf of ________________________________________ in the above referenced case and states that (he or she) is a member in good standing of the Bar of a United States Court or the highest Court of any State, and is not eligible for admission under Rule 11-1(a), and neither resides nor maintains an office for the practice of law within the State of Georgia. Petitioner enters on the back hereof (his or her) residence address, office address and telephone number, the courts to which admitted to practice and the dates of admission as required by Local Rule 9010-2. Petitioner further states to this Court that ________________________________ has been designated as local counsel in this case. This _______ day of ________________,_______. _____________________________________ Attorney at Law CONSENT OF DESIGNATED LOCAL COUNSEL I, the undersigned, an active member in good standing with the State Bar of Georgia and the Bar of the United States District Court for the Northern District of Georgia, having an office located at ____________________________ _______________, telephone number ( ) _______________, do hereby consent, as designated local counsel, to readily communicate with opposing counsel and the Court regarding the conduct of this case and to accept papers when served. I further acknowledge that if the above named petitioner fails to respond to any order of the Court for appearance or otherwise, pursuant to Local Rule 9010-2, I shall have the responsibility and full authority to act for an on behalf of the client in all proceedings in connection with this case, including hearings, pretrial conferences and trials. This _______ day of _________________, ________. __________________________________________ Designated Local Counsel __________________________________________ F69 (prohac vce) Revised 12/08 page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com Georgia Bar Number NAME OF PETITIONER _________________________________________________________ (Pro Hac Vice Applicant) Residence Address _________________________________________________________ _________________________________________________________ Business Address _________________________________________________________ Firm or Business Name __________________________________________________________ __________________________________________________________ __________________________________________________________ Telephone Number Courts To Which Admitted: Location Date Admitted Bar ID No. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ F69 (prohac vce) Revised 12/08 page 3 of 4 American LegalNet, Inc. www.FormsWorkflow.com IN THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF GEORGIA IN RE: _________________________________ _________________________________ Debtor(s) USBC CASE NO.: _________________ ADVERSARY NO.: _________________ _________________________________ Plaintiff v. _________________________________ Defendant ORDER OF ADMISSION PRO HAC VICE It appearing to the Court that ________________________________________, Attorney at Law states under penalty of perjury meets the requirements for admission pro hac vice as set forth in Local Rule 9010-2 and is in good standing and eligible to practice in all Courts to which admitted, it is therefor, ORDERED by the Court that the petition of _____________________________ to appear pro hac vice on behalf of _________________________________ in the United States Bankruptcy Court, Northern District of Georgia in the above referenced case be granted. This _______ day of _____________________________, ________. __________________________________________ UNITED STATES BANKRUPTCY JUDGE American LegalNet, Inc. www.FormsWorkflow.com