UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF GEORGIA 2211 United States Courthouse, 75 Spring Street, S.W. Atlanta, Georgia 30303-3361 404-215-1600 ATTORNEY ADMISSION APPLICATION ELIGIBILITY : Any attorney who is an active member in good standing of the State Bar of Georgia, (LR 83.1). PLEASE READ COMPLETELY GENERAL INFORMATION Fee : $150.00 - cash or check (payable to "Clerk, U.S. District Court"). Checks are accepted subject to collection. Date : In Atlanta, admissions proceedings are conducted every Monday morning. (Attorney admissions will no longer be held on Tuesday if Monday is a holiday.) No appointment necessary. In Gainesville, Newnan, and Rome, proceedings are not conducted weekly and you must call in advance for an appearance date. Time : In Atlanta, report (with completed application, fee and, sponsoring attorney) between 8:00 and 9:00 A.M. Attorneys must be processed and in the designated courtroom by 9:20 A.M. The Admissions proceedings in open court begin promptly at 9:30 A.M. Place(s) : Atlanta: Gainesville: Newnan: Rome: Application : 1. Bring it with you. Those received in the mail will be returned. 2. Complete all blanks except for the judge's signature line. A fillable form is available online at www.gand.uscourts.gov. Room 2216, 75 Spring Street, S.W. (404-215-1600) Room 201, 121 Spring Street (678-450-2760) Room 352, 18 Greenville Street (678-423-3060) Room 304, 600 East First Street (706-378-4060) 3. Mandatory : The signatures of two sponsors are required; all attorneys signing this form are subject to verification of enrollment and good standing with the State Bar of Georgia prior to application approval. The attorney moving for applicant's admission signs on the third line (the moving attorney can be one of your sponsoring attorneys). All sponsoring attorneys must be active members of the Bar of this Court. Their names must be typed to the right of their signatures. MUST personally appear to take the oath AND MUST be accompanied by a member in good standing of the Bar of this Court to move for applicant's admission in open court. A State Bar of Georgia bar card and photo identification are required. Criminal/Disciplinary Record : Include traffic violations. Date, location and brief description of infraction required. A Department of Motor Vehicles Report is NOT required. Questions : 404-215-1600 Notice : Members of the Bar of the Northern District of Georgia are required to register for Electronic Case Filing. Please register online at www.gand.uscourts.gov. Revised 07/31/08 American LegalNet, Inc. www.FormsWorkflow.com UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF GEORGIA TO: THE HONORABLE JUDGES THE PETITION of , a resident of the County , State of , shows that (he/she) is an active member in good of standing of the State Bar of Georgia and has been admitted to practice law in the Superior Court of ___________________ County, State of Georgia, and that (he/she) is at present an Attorney at Law practicing in said court; and provides herein as required (his/her) general and legal education, other courts to which admitted to practice, residence and business addresses and telephone numbers, and criminal or disciplinary record. WHEREFORE, (he/she) prays Your Honors that (he/she) may be admitted to plead and practice law in the United States District Court, in and for the Northern District of Georgia. day of , 20 . This Signature of Petitioner Georgia Bar Number CERTIFICATE OF SPONSORING ATTORNEYS We, the undersigned, active members in good standing of the State Bar of Georgia and the Bar of the United States District Court for the Northern District of Georgia, do hereby certify that we are personally acquainted with , who makes the above application; that (he/she) is of good moral character, an active member in good standing of the State Bar of Georgia and is a respectable practicing attorney in the Superior Court of the State of Georgia. day of , 20 . This Attorney at Law Georgia Bar Number Attorney at Law Georgia Bar Number Attorney Moving for Admission Georgia Bar Number ORDER OF ADMISSION It appearing to the Court that , a resident in the County of , State of , is an active member in good standing of the State Bar of Georgia and has been admitted to practice law in the Superior Court of the State of Georgia; that (he/she) is a respectable practicing attorney in said court, and is of good moral character, it is therefore, CONSIDERED AND ORDERED that the said be accorded all the privileges granted attorneys in the United States District Court for the Northern District of Georgia, upon taking the Oath, and that a Certificate of Admission to the Bar of this Court be issued. This day of , 20 . UNITED STATES DISTRICT JUDGE American LegalNet, Inc. www.FormsWorkflow.com NOTE: USE THE REVERSE SIDE OF THIS PAGE IF MORE SPACE IS NEEDED. EDUCATION General (Institution, Degree, Year Received) __________________________________________________________________________________ __________________________________________________________________________________ Legal (Institution, Degree, Year Received) __________________________________________________________________________________ __________________________________________________________________________________ COURTS TO WHICH ADMITTED (Identify Court and Location) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ RESIDENCE/BUSINESS ADDRESS AND TELEPHONE INFORMATION (LR 11.1 requires street and P.O. Box/Drawer number if appropriate.) Residence Business Street:______________________ Apt.______ City / State:____________________________ Telephone: ( )______________________ Firm/Company:_____________________________ Street:______________________Suite: _________ City/State: _____________________Zip:________ P.O. Box/Drawer:________________Zip:________ Telephone: ( )____________________________ CRIMINAL/DISCIPLINARY RECORD 1. (a) Have you ever pled guilty to or been adjudicated guilty of a violation of any law? Yes____No____ (b) Have you ever entered a plea of nolo contendre to criminal charges? Yes____No____ (c) If the answer to either (a) or (b) above is “yes”, provide an explanation for each offense including the nature of the offense, the name of the court, the disposition (including punishment, if any), the dates on which the charges were brought and adjudicated, and any subsequent history relating to the charges. 2. (a) Have you ever been the subject of any form of lawyer discipline, whether private or public, whether oral or written, in any jurisdiction or court in which you have been admitted to the practice of law? Yes_____No_____ (b) If you answered “yes” to the above question, provide an explanation for each instance including the name of the jurisdiction or court imposing the discipline, the date of the discipline, the nature of the discipline, the nature of the offense for which the discipline was imposed, and any other information you deem appropriate. RELEASE and CERTIFICATION I, the undersigned applicant for admission to the bar of the U.S. District Court, Northern District of Georgia, do hereby authorize the “Board to Determine Fitness of Bar Applicants of the State of Georgia” and the licensing boards of any other state or federal courts which investigated me prior to admitting me to the practice of law in that jurisdiction or court to release to the U.S. District Court for the Northern District of Georgia any information which may be contained in said board’s background investigation of me, should said Court, in its discretion, request that such information be made available; FURTHER, I hereby certify that the information provided in this application for admission regarding my educational, legal, disciplinary, and personal background is true and complete of my own knowledge. I have typewritten the answers or they have been typewritten under my supervision. This _________day of____________________________, 20_____. ____________________________________________________ Signature of Applicant American LegalNet, Inc. www.FormsWorkflow.com United States District Court for the NORTHERN DISTRICT OF GEORGIA In the matter of: Attorney at law State Bar of Georgia No. APPLICATION FOR, AND ORDER OF, ADMISSION TO THE BAR FILED IN THE CLERK'S OFFICE (DATE) JAMES N. HATTEN, Clerk By: Deputy Clerk Recorded upon the Minutes Admission fee paid American LegalNet, Inc. www.FormsWorkflow.com