UNITED STATES DISTRICT COURT District of Minnesota PETITION FOR ADMISSION TO PRACTICE Effective October 5, 2015 � To apply for admission this completed form along with the certificates MUST be uploaded through the Petitioner's upgraded individual PACER account to the "Attorney Admissions and E-File" option for the District of Minnesota. I, , petition the United States District Court for the District of Minnesota for Admission to Practice. In accordance with Local Rule 83.5(c), I submit the following information in support of my Petition: Petitioner Residence and Office Addresses Residential Address: Office Name: Address: Phone: ( ) Phone: Fax: Email: ( ( ) ) All Courts in which Petitioner is Admitted Minnesota Attorney License Number: Date of Admission to the Minnesota Supreme Court: All other courts in which I am admitted: Legal Training and Experience at the Bar Law School attended and date of graduation: Years I have practiced law: Page 1 American LegalNet, Inc. www.FormsWorkFlow.com Brief description of legal experience: _______________________________________________________________________________ I attest that the information provided above to support my Petition for Admission to Practice is true and correct and that I am a member in good standing of all the courts to which I am admitted identified above. Date: Certification of Petitioner I, , the undersigned petitioner, do hereby certify that I have read and am familiar with the Federal Rules of Civil Procedure, the Federal Rules of Criminal Procedure, the Federal Rules of Evidence, and the Local Rules of the Court, including the Electronic Case Filing Procedures. Date: Admission Ceremony Information Check one of the following: I request to attend the Admissions Ceremony in Minneapolis on I request to attend the Admissions Ceremony in St. Paul on I have scheduled an Admission Ceremony in Duluth for I have scheduled an Admission Ceremony in Fergus Falls for . . . . Signature: Signature: The Clerk's Office will contact you if your selected admission ceremony date cannot be accommodated. Admission ceremony information for Minneapolis and St. Paul can be found online at www.mnd.uscourts.gov on the INFORMATION page of our website. To schedule an admission ceremony in Duluth or Fergus Falls, please contact Magistrate Judge Brisbois' Chambers directly at (218) 529-3520. For questions, please email the ecf helpdesk at ecfhelpdesk@mnd.uscourts.gov or contact an Attorney Admissions Clerk at 651-848-1100. IMPORTANT: Once this form is complete AND you have your two certificates from active members of this Court's bar, you will apply for admission through your upgraded individual PACER ACCOUNT. These documents WILL BE UPLOADED through PACER to the "ATTORNEY ADMISSIONS AND E-FILE" option for the District of Minnesota. Click here for detailed step by step instructions. DO NOT MAIL OR DELIVER ANYTHING TO THE COURT. Page 2 American LegalNet, Inc. www.FormsWorkFlow.com