U.S. District Court for the Northern District Of Illinois Attorney Appearance Form Case Title: Case Number: An appearance is hereby filed by the undersigned as attorney for: Attorney name (type or print): Firm: Street address: City/State/Zip: Bar ID Number: (See item 3 in instructions) Telephone Number: Email Address: Are you acting as lead counsel in this case? Are you acting as local counsel in this case? Are you a member of the court's trial bar? If this case reaches trial, will you act as the trial attorney? If this is a criminal case, check your status. Yes Yes Yes Yes No No No No Retained Counsel Appointed Counsel If appointed counsel, are you a Federal Defender CJA Panel Attorney ______________________________________________________________________ In order to appear before this Court an attorney must either be a member in good standing of this Court's general bar or be granted leave to appear pro hac vice as provided for by local rules 83.12 through 83.14. I declare under penalty of perjury that the foregoing is true and correct. Under 28 U.S.C.§1746, this statement under perjury has the same force and effect as a sworn statement made under oath. Executed on Attorney signature: S/ (Use electronic signature if the appearance form is filed electronically.) Revised 8/1/2015 American LegalNet, Inc. www.FormsWorkFlow.com