IN THE CIRCUIT COURT FOR THE THIRD JUDICIAL CIRCUIT MADISON COUNTY, ILLINOIS ____________________________________, Plaintiff(s) Vs. Case No. __________________ (All required information must be typed or legibly printed.) ____________________________________, Defendant(s) APPLICATION FOR ADMISSION OF COUNSEL PRO HAC VICE I, ______________________________, pursuant to Supreme Court Rule 707 and the Local Rules of the Third Judicial Circuit, hereby request permission to appear and participate as an attorney at law in the above entitled cause, on behalf of ____________________________________________________, a party in this cause. In support of this application, and under penalties of perjury as provided by law pursuant to Section 1-109 of the Illinois Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, and therefore states as follow: 1. My name is ________________________________________________________. All other names that I have ever used or been known by are: _________________________ __________________________________________________________________________. 2. I am a licensed attorney and counselor at law in good standing in the State of ______________________, where I most regularly practice law. My attorney registration number in that State is __________________. 3. In addition, I am licensed to practice law in the State(s) of ________________ ________________________________________, and am admitted to practice before the following federal courts: ___________________________________________________. 4 I have never taken the Illinois bar examination, or I have taken but did not pass the Illinois bar examination in _______year(s). Exhibit to Motion for Admission Pro Hac Vice Page 1 of 3 Case No. __________ American LegalNet, Inc. www.FormsWorkFlow.com 5. I have never been licensed to practice law in the State of Illinois, or I was licensed to practice law in the State of Illinois from ___________ to ____________, but am no longer licensed to practice law in the State of Illinois. The reason that I am no longer licensed to practice law in the State of Illinois is that: ________________________________________________________________________ 6. I have never applied for reciprocity in the State of Illinois, or I have applied for reciprocity in Illinois but was denied. If so, state when, where, and the reason for the denial(s) and attach a copy of any order(s) denying your application(s)). _________________________________________________________________________ 7. I have made prior successful pro hac vice applications in the State of Illinois. If so, state the most recent year you have applied _________ and the approximate number of applications made in your career to date? twenty-five (25), a) fewer than ten (10), (c) twenty-five (25) to fifty (50), (b) ten(10) to (d) more than fifty or. I have been denied admittance pro hac vice by court(s) in Illinois or another state. If so, state when, where and the reason for the denial(s) and attach a copy of any order(s) denying your application(s). ____________________________________________________ 8. Other attorney(s) in my present law firm have been admitted to practice in the courts of the State of Illinois on a Motion to appear pro hac vice. If so, provide the names of each attorney and the approximate number of times each attorney was admitted using the same (a), (b), (c), and (d) categories used in the question above: Additional pages may be attached. ___________________________________________________________________________ ____________________________________________________________________________ 9. Other attorney(s) in my present law firm have been denied leave to appear pro hac vice in this or another State(s). If so, the applicant must also attach a copy of the Order(s) entered denying such application(s). 10. I have never been censured, sanctioned, suspended, disbarred, or otherwise disciplined by any attorney disciplinary authority of any state, or The following disciplinary proceedings have been instituted against me: List all disciplinary actions in any State and attach copies of any rulings or dispositions. ___________________________________________________________________________ ____________________________________________________________________________ Exhibit to Motion for Admission Pro Hac Vice Page 2 of 3 Case No. __________ American LegalNet, Inc. www.FormsWorkFlow.com 11. I have never been sanctioned or held in contempt by any Judge, agency or other tribunal other than as set forth 10 hereinabove or I have been sanctioned or held in contempt by a Judge, agency or other tribunal. If so, applicant must attach a copy of every written Order that entered a sanction or found the applicant to be in contempt of court. 12. ___________________________(name) _________________________address), _______________(phone number)___________ (Illinois registration number), an attorney licensed in the State of Illinois, has been retained as a local attorney and to file the Motion for Leave to Appear Pro Hac Vice to which this application is attached. 13. I have read, am familiar with, and will abide by, the Illinois Code of Civil Procedure, Illinois Supreme Court Rules, and Local Rules of the Third Judicial Circuit. In particular, I have read and am familiar with Supreme Court Rule 137 concerning sanctions and agree to be bound by the Illinois Rules of Professional Conduct for attorneys. 14. Applicant agrees to immediately notify the Court and all counsel of record in the event any information provided in this application changes or becomes inaccurate. 15. Applicant authorizes the Administrator of any attorney registration and disciplinary authority to disclose to the Presiding Judge in this cause all information contained in the files of such authority concerning his or her current status, any complaints that have been made, and the disposition thereof. Applicant expressly waives any right to confidentiality of any such information that may be required by any Supreme Court Rule and/or by any other statute, rule or regulation providing for confidentiality by such authority. Name of Applicant: _____________________________________________________ Firm name, if any: ____________________________________________________ Business address: ______________________________________________________ Telephone: ______________________ E-mail: __________________________ Signature: _________________________________________________ Exhibit to Motion for Admission Pro Hac Vice Page 3 of 3 Case No. __________ American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT FOR THE THIRD JUDICIAL CIRCUIT MADISON COUNTY, ILLINOIS ____________________________________, Plaintiff(s) Vs. Case No. __________________ (All required information must be typed or legibly printed.) ____________________________________, Defendant(s) MOTION FOR ADMISSION OF COUNSEL PRO HAC VICE Comes now ______________________, attorney for _________________, and requests this court grant the application for admission submitted by attorney __________________, and states as follows: 1. That the undersigned is an attorney licensed to practice law in the state of Illinois. 2. That __________________ is an attorney in good standing in the State of ____________________ and has completed the application attached as an exhibit to this motion. 3. That the undersigned is aware and agrees that if the court grants this motion s/he remains designated as local counsel on behalf of the party in this matter. Wherefore, the undersigned prays this court enter an order granting the motion for admission pro hac vice, for this case only, on behalf of the applicant. ___________________________ Attorney name and ARDC number Attorney contact information Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT FOR THE THIRD JUDICIAL CIRCUIT MADISON COUNTY, ILLINOIS ____________________________________, Plaintiff(s) Vs. Case No. __________________ (All required information must be typed or legibly printed.) ____________________________________, Defendant(s) ORDER FOR ADMISSION OF COUNSEL PRO HAC VICE The above-entitled matter having come before the court on the motion of counsel accompanied by the application of ________________________ to be admitted to appear and participate in the above entitled cause, and the court being fully advised in the premises: A. IT IS ORDERED that said Motion for Admission of Counsel Pro Hac Vice is granted for this case only. Attorney ________________________ is hereby allowed to appear and participate on behalf of ____________________________, a party in this case. B. The court notes that this party is now represented by more than one attorney. It is hereby ORDERED that ____________________, an attorney duly licensed in the State of Illinois, remains or is designated as local counsel for said party. Service on local counsel of notices and copies of pleadings directed to the party represented by that local counsel is sufficient and need not be made on other attorneys representing the same party. Further, if directed by the court, local counsel shall be responsible for sending notice to co-counsel and opposing counsel of hearings to be held on motions before the court. The clerk is to send copies of this order to the attorneys of record. Date: _________________________________ ___________________________ Judge Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com