Nebraska State Court Form MOTION FOR PRO HAC VICE ADMISSION Ch.3, Art.1, App.B Amended 07/2014 Neb. Ct. R. §3-122 IN THE _____________________ COURT OF ______________________________ __________________________, Plaintiff, v. __________________________, Defendant, Case No. _____________ MOTION FOR PRO HAC VICE ADMISSION (To be completed by associated counsel licensed in Nebraska). ______________________ hereby moves this Court to grant _____________________ admission pro (Attorney) (Applicant) hac vice in the above-captioned case, as co-counsel for the plaintiff/defendant. __________________________ is a resident of Nebraska, duly and regularly admitted to practice in (Attorney) the courts of record of this state, and service may be had in all matters connected with this action. __________________________, or my designee who shall be licensed to practice in the courts of (Attorney) record of this state, will sign all pleadings, motions, and papers filed in the case, as well as personally appear at all proceedings before the court, unless excused by the court. In support of this motion, please see the attached application signed by the applicant. Wherefore, ______________________________, respectfully moves this Court for admission pro hac (Attorney) vice for__________________________________ in the above-captioned case. (Applicant) /s/ Attorney Name (Bar Number) Firm Name Street Address/P.O. Box Number City/State/ZIP Code Telephone E-mail Address Page 1 of 3 (Motion) Pro Hac Vice Admission Ch3Art1AppB Amended 07/2014 Appendix B (Neb. Ct. R. ­ Chapter 3, Article 1) American LegalNet, Inc. www.FormsWorkFlow.com Nebraska State Court Form APPLICATION FOR PRO HAC VICE ADMISSION (To be attached to Motion for Admission Pro Hac Vice) Attorney Name:______________________________________ (Applicant) Ch.3, Art.1, App.B Amended 07/2014 Neb. Ct. R. §3-122 Vs. Case Caption:_________________________________________________________________ Case Number:________________________________________ Court in which you are requesting admission pro hac vice: _____________________________ ______________________________, desiring admission pro hac vice in the above-stated matter, affirms as follows: _____________________________ is an attorney admitted and eligible to practice law in _________________________ and is a member in good standing in ___________________________. (State(s)) (State(s)) _____________________________ is not the subject of a disciplinary action or investigation. (If subject to a disciplinary action or investigation, complete next paragraph). _____________________________ is the subject of a disciplinary action or investigation in _______________________________ and the name and address of the disciplinary authority is: (State(s)) ____________________________________ __________________________________________. The nature and status of the disciplinary action or investigation is _____________________________________________________________________. (Please attach additional pages if necessary). ______________________________, upon admission pro hac vice, will be subject to the Rules of Professional Conduct, Neb. Ct. R. of Prof. Cond. §§ 3-501.0 to 3-508.5. ______________________________ has associated with the following attorney who is duly and regularly admitted to practice in the courts of record of this state, and upon whom service may be had in all matters connected with the action: Name of Local Counsel and Bar Number: ________________________________________________. ______________________________ has paid the $250 fee to the Clerk of the Court. /s/ Attorney Name (Foreign Bar Number) Firm Name Street Address/P.O. Box Number City/State/ZIP Code Telephone Page 2 of 3 (Application) Pro Hac Vice Admission Ch3Art1AppB Amended 07/2014 E-mail Address Appendix B (Neb. Ct. R. ­ Chapter 3, Article 1) American LegalNet, Inc. www.FormsWorkFlow.com Nebraska State Court Form OATH SUBCRIBED TO BY PRO HAC VICE APPLICANT Ch.3, Art.1, App.B Amended 07/2014 Neb. Ct. R. §3-122 IN THE _____________________ COURT OF ______________________________ __________________________, Case No. _____________ Plaintiff, v. __________________________, Defendant. OATH SUBCRIBED TO BY PRO HAC VICE APPLICANT I, the undersigned attorney, do solemnly swear that I will support the Constitution of the United States, and the Constitution of the State of Nebraska, and that I will faithfully discharge the duties of an attorney and counselor, according to the best of my ability. Dated this __________ day of ____________________, 20____. ____________________________________ Attorney Subscribed and sworn to before me this __________ day of ____________________, 20____. ____________________________________ Person Administering Oath Pursuant to Neb. Rev. Stat. § 24-1002 Page 3 of 3 (Oath) Pro Hac Vice Admission Ch3Art1AppB Amended 07/2014 Appendix B (Neb. Ct. R. ­ Chapter 3, Article 1) Appendix B adopted April 13, 2011, effective July 1, 2011; amended January 30, 2014; amended July 2, 2014. American LegalNet, Inc. www.FormsWorkFlow.com