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Personal Data Sheet (Application For Judicial Vacancy) Form. This is a Nebraska form and can be use in General Statewide.
Tags: Personal Data Sheet (Application For Judicial Vacancy), Nebraska Statewide, General
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
PERSONAL DATA SHEET
Calendar No.
Nebraska Judicial Nominating Commission
:
Plaintiff(s)
JUDICIAL SUBPOENA
________________________________________________________________
-against- for which application is being :submitted
Court
:
This data sheet is a confidential communication between the
Judicial Nominating Commission, the applicant, and the Governor.
:
Defendant(s)
:
. . . . . . . . . . . . . . . . .INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL . . . . . . . . . . . .
1.
Full Name
First
Middle
Last
THE PEOPLE OF THE STATE OF NEW YORK
2.
TO
3.
Social Security Number:
Date of Birth:
/
Mo.
-
-
/
Day
Yr.
GREETINGS:
EDUCATION
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
4.
List
you have attended or any courses on law you have taught or
,
the Honorableany continuing legal education programsat the
Court
lectures you have given at bar association conferences, law school forums, or continuing legal education
located at
County of
programs that you feel would be of benefit to the commission. (Please limit to the past 5 years.)
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf thisBUSINESS INVOLVEMENT a maximum penalty of $50 and all damages sustained as a
EMPLOYMENT AND subpoena was issued for
result of your failure to comply.
5.
If you were in the armed services, were you ever discharged under conditions other than honorable?
yes
Witness, Honorable no If yes, please explain.
, one of the Justices of the
Court in
6.
County,
day of
, 20
List any occupation, business or profession, other than the practice of law, in which you have engaged. Give
details, including dates. If you are now an officer, director(Attorney must engaged in the management of any
or otherwise sign above and type name below)
business enterprise, state the name of such enterprise, the nature of the business, and the nature of your duties.
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
08/03 - Pg. 1 of 6, PDS
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COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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:
7.
Have you ever held public office?
Yes
Index No.
No. If yes, state the office, location, and dates of service.
:
Plaintiff(s)
-against-
Calendar No.
:
JUDICIAL SUBPOENA
:
:
LEGAL CAREER
:
8.
If currently practicing law, describe the Defendant(s) of your practice over the last 5 years, including any
general character
:
. . . . . . . . . . . . . . specialization .and .trial.work, if.any. . . . . . . . . . . . . . .
areas of . . . . . . . . . . . . . . . . . . . . . .
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
9.
If you are not practicing law, please provide details of your current occupation.
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
10.
If you are not currently practicing law, but you have practiced in the past, give the dates and general nature of
that practice.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
11.
Witness, Honorable
, one of the Justices of the
Have you or your professional liability carrier ever settled a claim against you (based on your alleged
Court in misconduct orCounty, notday of
, 20
negligence,
your partner's or firm's) for professional malpractice? If so, give particulars.
(Attorney must sign above and type name below)
Attorney(s) for
12.
Describe pro bono legal work or community service work you have done in the past 5 years that you feel would
be of interest to the commission.
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
08/03 - Pg. 2 of 6, PDS
American LegalNet, Inc.
www.USCourtForms.com
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......... ..
:
Index No.
13.
All applicants for judicial vacancies in Nebraska must attach an example of legal writing which was authored
:
solely by the applicant.
Calendar No.
14.
:
To your knowledge, are you currently under investigation by any disciplinary committee of the Nebraska State
JUDICIAL SUBPOENA
Plaintiff(s)
Bar Association, by the Supreme Court of the State of Nebraska, by the Nebraska Judicial Qualifications
Commission, or by -against-committee or court in any state? If so, please give particulars.
a similar
:
:
:
Defendant(s)
:
......................................................
HONORS AND PUBLICATIONS
THE PEOPLE OF THE STATE OFbooks or articles or given any speeches or lectures that you would like the
15.
If you have published any NEW YORK
commission to consider, please list them, giving dates.
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located
County ofFINANCIAL CIRCUMSTANCES at
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or16.
adjourned date, to testify andor any evidence as awhich you ownedactionthan the part of theunder title 11 of the
Have you, your spouse, give corporation of witness in this more on 25% ever filed
U.S. Bankruptcy Code?
Yes
No. If so, give details.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
MEMBERSHIPS AND ACTIVITIES
17.
List any organizations, including bar associations and professional societies, of which you have been a member
Witness, Honorable
, one of the Justices of the
since graduating from law school. Include the titles and dates of any offices which you have held in each such
Court in organization. County,
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
08/03 - Pg. 3 of 6, PDS
American LegalNet, Inc.
www.USCourtForms.com
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:
18.
Index No.
Do you now or have you ever belonged to any club or organization that in practice or policy prohibits (or
:
prohibited during the time of your membership) membership on the basis of race, religion, national origin, or sex?
Calendar No.
:
Yes
No. If so, detail the name and nature of the club or organization, relevant policies and practices,
JUDICIAL SUBPOENA
Plaintiff(s)
and whether you intend to continue as a member if you are selected to serve on the bench.
-against-
:
:
19.
:
Have you ever served on this particular nominating commission?
that your term expired or you resigned? Defendant(s)
.
Yes
No. If so, what was the date
:
......................................................
MISCELLANEOUS
20.
Have you read the Code of Judicial Conduct attached to the Application for Judicial Vacancy and are you able
THE PEOPLE OF THE STATE ______ YesYORK No
to comply if appointed? OF NEW ______
21.
TO
Have you ever been a party to a lawsuit, excluding divorce?
Yes
No. If so, please indicate nature of
lawsuit, whether you were plaintiff or defendant, disposition of case, and location of lawsuit.
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
22.
Describe any additional education or other experience you have which could assist you in holding judicial
office.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
23.
Are there currently any judgments or income tax liens outstanding against you?
Yes
No. If so,
please indicate the nature and location of the judgment(s) or(Attorney must sign above and type name below)
lien(s).
24.
Have you ever been charged by law enforcement authoritiesAttorney(s) of any laws? If so, please give details.
for violation for
Do not include traffic violations unless they also included a potential jail sentence.
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
08/03 - Pg. 4 of 6, PDS
American LegalNet, Inc.
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......... ..
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Index No.
:
Calendar No.
:
JUDICIAL SUBPOENA
REFERENCES
Plaintiff(s)
25.
-againstList the names of up to five judges who would be in a position : comment on your qualifications for this judicial
to
position. Please give addresses of any out-of-state or retired judges.
:
1.
:
2.
Defendant(s)
:
3.
......................................................
4.
5.
THE PEOPLE OF THE STATE OF NEW YORK
TO
26.
List the names and addresses of five persons who are in a position to comment on your qualifications for this
judicial position and of whom inquiry may be made by the commission. (Do not list the references listed in items
GREETINGS: 27 or members of the Judicial Nominating Commission for this position.)
25 or
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
08/03 - Pg. 5 of 6, PDS
American LegalNet, Inc.
www.USCourtForms.com
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COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
27.
Index No.
If you practice law, please list the names and addresses of five opposing counsel who are in a position to
:
comment upon your abilities. If you do not practice law, please list the names and addresses of five members of
Calendar No.
the legal profession who are in a position to comment upon your abilities. (Do not list the references listed in
:
items 25 or 26 or members of the Judicial Nominating Commission for this position.)
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
:
:
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Please return original copy plus 16 copies promptly to the Supreme Court Chair of the Judicial Nominating Commis sion to
which you are making application.
Send to:
Office and P.O. Address
Nebraska Supreme Court
P.O. Box 98910
Lincoln, Nebraska 68509
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
08/03 - Pg. 6 of 6, PDS
American LegalNet, Inc.
www.USCourtForms.com
