B-9010-2 Pro Hac Vice (rev 120116) UNITED STATES BANKRUPTCY COURT Southern District of Indiana (Insert Bankruptcy Case or Adversary Proceeding Caption here.) MOTION TO APPEAR PRO HAC VICE (Name of applicant) of (name of law firm, if any) moves the Court for an order granting admission pro hac vice for the purpose of appearing as counsel on behalf of (name of party being represented) in the above-styled cause only. In support of this motion, the applicant states: 1. The court(s) in which I am admitted to practice and the date(s) of admission are as follows: Date(s) of Admission (month/year) Example: October 2005 Court(s) Example: Northern District of Indiana (If additional courts are to be listed, attach a separate sheet.) 2. The applicant is not currently under suspension or subject to other disciplinary action with respect to the practice of law. (If the applicant is not admitted to practice in the State of Indiana) Accompanying this motion is an affidavit, as required by S.D.Ind. L.R. B9010-2. 3. WHEREFORE, the applicant requests this Court enter an order of admission pro hac vice for purposes of this cause only. /s/ Name of Applicant Name of Applicant (required signature block) 1 American LegalNet, Inc. www.FormsWorkFlow.com B-9010-2 Pro Hac Vice (rev 120116) CERTIFICATE OF SERVICE (Certificates of Service forms are available on the Court's website under Rules & Forms > Local Forms > Motions & Related Notices/Certificates of Service/Orders) Notes: Pursuant to Local Rule B-9010-2 attorneys who practice in the Bankruptcy Courts of the Southern District of Indiana must be admitted to practice in the Southern District or must obtain leave of this Court to appear pro hac vice. Local Rule B-5005-1(a) requires attorneys to file all documents electronically. This requirement applies to any motion to appear pro hac vice. The applicant can obtain a user ID and password and training on the electronic filing process by following the direction on the Court's website. An attorney who is not admitted to practice in the State of Indiana must provide an affidavit confirming admission in another jurisdiction. The Court can verify admission in Indiana easily, but verifying admission in other jurisdictions is more challenging and time-consuming. Therefore, the Court requires the applicant to provide an affidavit. 2 American LegalNet, Inc. www.FormsWorkFlow.com