Appendix V: AFFIDAVIT OF CLE TRANSFER MINNESOTA STATE BOARD OF CONTINUING LEGAL EDUCATION 180 E. 5th Street, Suite 950 St. Paul, Minnesota 55101 651-297-7100 www.cle.mn.gov License Number: Name: Telephone Number: Address: Email Address: City, State, Zip: Request to transfer from Lawyer Signature Date: American LegalNet, Inc. www.FormsWorkFlow.com ATTENDANCE INFORMATION: Please include the Sponsor, Course Title, Event Code (if known), Course Dates, Number of Credits for Attendance, and Total Credits. Additionally, if you are claiming teaching credit per Rule 7A , you may add that to this chart. You may not claim teaching credit for On-Demand courses. SPONSORING AGENCY COURSE TITLE EVENT CODE * COURSE DATE(S) STANDARD (inc. Prof Dvlpmt/Law Office Mngt) ETHICS ELIM OF BIAS ON-DEMAND (Y/N) ** TEACHING CREDIT TOTAL CREDITS 1. 2. 3. 4. 5. 6. 7. 8 . 9 . (USE ADDITIONAL SHEETS IF NECESSARY) * You must provide a detailed course agenda if the course(s) you have attended have not been approved for CLE credit in Minnesota. Additional course description information may be requested. ** On-Demand courses are capped at 15 credits per 3-year reporting period Please retain a copy of this form for your records American LegalNet, Inc. www.FormsWorkFlow.com DISCRETIONARY TRANSFER PLAN DETAILS I am requesting discretionary transfer under Rule 12 C(2)(b) and/or 12D(2). I have reported the completion of credits and provided a plan (below) to complete the remaining credits by (please include month/day/year). Lawyers must report at least 45 credit hours, including 3 hours of Ethics CLE and at least 2 hours of Elimination of Bias CLE to seek a discretionary transfer. You may report more than the minimum required number of ethics and bias credits. All ethics and bias credits count towards your requirement. No more than 15 credits per 45 credit reporting period may be On-Demand. DISCRETIONARY TRANSFER 226 COURSES TO FULFILL REMAINING REQUIREMENTS SPONSORING AGENCY COURSE TITLE EVENT CODE * COURSE DATE(S) STANDARD (inc. Prof Dev and LOM) ETHICS ELIM OF BIAS ON-DEMAND (Y/N)** TOTAL CREDITS 1. 2. 3. 4. 5. 6 . 7. 8. 9. 10. 11. 12. American LegalNet, Inc. www.FormsWorkFlow.com