RENEWAL OF ATTORNEY SPECIALTY FORM: RPC 7.4(d)(3)(i) State Bar of Nevada PO Box 50 Las Vegas, NV 89125-0050 Phone: (702) 382-2200 Toll Free (800) 254-2797 Fax: (702) 385-2878 DATE SUBMITTED: __________________ SUBMITTED BY: _________________________________ ____________ (Attorney name) (Bar number) _________________________________ (Firm name) _________________________________ (Address) _________________________________ _________________________________ (Phone number) _________________________________ (E-mail) 1. Specialty registered: __________________________________ (List as you will be advertising your specialty) Proof of certification attached. Certification issued by: __________________________________ (Name of approved organization that certifies you) This certification was first issued _______ and is valid through _________. (Date) (Date) 2. Are you registering more than one specialty? Yes No You must attach a completed copy of this form, with the exception of #3 (fee) for each additional specialty (up to three total). There is only (1) fee if you register multiple specialties at this time or at annual renewal. Please staple forms together. 3. Process my $250 renewal fee by: Check (enclosed) Please mail original application with payment to: State Bar of Nevada PO Box 50 Las Vegas, NV 89125-0050 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 4. Attestation. By signing and submitting this form, the undersigned attests to compliance with each of the following (initial each item): _____ I have verified that the organization which certifies my specialty as designated in item #2 herein is currently ABA Certified, or, approved by the State Bar of Nevada Board of Governors. _____ I have devoted at least one-third of my practice to the specialty designated in item #1 herein for the past two (2) years. _____ I have completed ten (10) hours of continuing legal education in the area of my designated specialty in the past year as follows: Proof of attendance attached OR List courses below: ___________________________________________ ___________________________________________ ___________________________________________ ______ Professional liability insurance verification- Complete one of the following as it applies to you: _____ I currently carry at least $500,000 in professional liability insurance. Proof of my coverage is attached. (Required. SCR 198(3)(b)(iii). ) ______ I am exempt from liability coverage under Rule 198 because I practice exclusively public law. ______ I am concurrently filing a copy of this form and its attachments with the Mandatory Board of Continuing Legal Education, 457 Court Street, Reno, NV 89501. (Required. SCR 198(3)(b)(iv).) SIGNATURE OF ATTORNEY REGISTERING SPECIALTY: I have personally read this form and attest to the accuracy of the information contained therein. Please do not fax this application as an original signature is needed. Dated this _______ day of ___________, ___________. _____________________________________________________ (Print Name) _____________________________________________________ (Sign Name) If you have questions, please call Mary Jorgensen at 702-317-1424. Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com