UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS (www.mad.uscourts.gov) ATTORNEY BAR RE-REGISTRATION AND APPLICATION FOR ELECTRONIC CASE FILING ACCOUNT Please type or print legibly NAME: ____________________________________________________________________________________________________________ (Last) (Generation) (First) (Middle Initial) If admitted to the Massachusetts State Bar or the United States District Court Bar under a different name, please indicate below: ____________________________________________________________________________________________________________ (Last) (Generation) (First) (Middle Initial) DATE OF BIRTH: _____________________ SSN#: ____________________ Law Firm: Building/Suite: Street Address: City, State, ZIP: Telephone: E-Mail: BBO# _________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _________________________________ Fax: ______________________________________ _______________________________________________________________________________ ADMISSION DATES: TO THE DIST. OF MASS. BAR: ____________ TO THE MASS. STATE BAR: ______________ CURRENT STATUS WITH THE MASSACHUSETTS STATE BAR: __ Active __ Suspended __ Disbarred __ In-Active __________________________ If your status is "suspended", what is your anticipated date of reinstatement to the bar: I hereby certify that; (1) I am currently in good standing as an attorney admitted to practice before the Supreme Judicial Court of Massachusetts [unless indicated otherwise in the current status section above] (2) I am familiar with the Local Rules of this District, and (3) the information contained in this application is true and correct. 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 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 combination of User ID and password will serve as the signature of the attorney filing the documents. 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. SIGNATURE: ________________________________________________________________________ DATE: _____________________________ ATTORNEYS ADMITTED PRIOR TO 2001 SHOULD MAIL OR HAND DELIVER THIS FORM TOGETHER WITH A $25.00 CHECK OR MONEY ORDER MADE PAYABLE TO "CLERK, UNITED STATES DISTRICT COURT"(Fee waived for attorneys admitted after January 1, 2001): Clerk, United States District Court Attn: Attorney Re-registration John Joseph Moakley United States Courthouse 1 Courthouse Way Suite 2300 Boston, MA 02210 Clerk's Office Use Only Date received: $25.00 fee receipted: Admission verified: Record updated: American LegalNet, Inc. www.FormsWorkFlow.com