UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS (www.mad.uscourts.gov) APPLICATION FOR ADMISSION Please type or print legibly NAME: ________________________________________________________________________ (Last) (Generation) (First) (Middle Initial) _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _________________________ Fax: ___________________________________________ Law Firm: Street Address: Building/Suite:: City, State, ZIP: Telephone: E-Mail: (for service of electronically filed documents) ___________________________________________ BBO#_____________________ DATE ADMITTED TO THE MASSACHUSETTS STATE BAR: _________________________ ELECTRONIC CASE FILING SYSTEM REGISTRATION Attorneys seeking to file documents electronically must be admitted to practice in this court pursuant to LR 83.5., represent the U.S. government or authorized to appear pro hac vice or through an MDL action. Your signature below indicates that you are registering for an account on the Court's Case Management/Electronic Case Files (CM/ECF) system and you agree to the requirements stated herin. Attorneys will have privileges to electronically file court documents, view official docket sheets and documents associated with cases, and query various case reports for cases on the CM/ECF system. The CM/ECF system follows and must be used in conjunction with the Federal Rules of Civil & Criminal Procedure, the Local Rules, and any administrative orders and policies of the United States District and Bankruptcy Courts for the District of Massachusetts. In order to file documents electronically, CM/ECF participants will need a PACER service account. By submitting this registration form, the undersigned agrees to abide by all Court rules, orders and policies and procedures governing the use of the electronic filing system. The undersigned also consents to receiving notice of filings pursuant to Federal Rules Civil Procedure, Federal Rules of Criminal Procedure and the Federal Rules of Bankruptcy Procedure via the Court's electronic filing system. The undersigned is also responsible for updating their ECF user account promptly when any information changes. The combination of User ID and password will serve as the signature of the attorney filing the documents for the purposes of Rule 11 of the Federal Rules of Civil Procedure. Attorneys must protect the security of their passwords and immediately notify the court if they learn that their password has been compromised. In that event, counsel must apply for a new password. I hereby certify that (1) I am currently in good standing as an attorney admitted to practice before the Supreme Judicial Court of Massachusetts, (2) I am familiar with the Local Rules of this District, and (3) the information contained in this application is true and correct. SIGNATURE: ______________________________________________ (Check 1): I wish to be sworn in at: Boston ( ) DATE: _________________________________ ) Worcester ( ) Springfield ( *PAYMENT WILL BE COLLECTED AT THE TIME OF THE CEREMONY* MAIL OR HAND DELIVER COMPLETED APPLICATION AND CERTIFICATE OF GOOD STANDING FROM THE MASSACHUSETTS SUPREME JUDICIAL COURT TO: United States District Court Attn: Tracy McLaughlin John Joseph Moakley United States Courthouse 1 Courthouse Way Suite 2300 Boston, MA 02210 Clerk's Office Use Only - (2/2/2012) All previous editions of the Admissions Application are obsolete. Date received: Admission date: Fee paid: CM/ECF Record updated: American LegalNet, Inc. www.FormsWorkFlow.com