Plaintiff or Filing Attorney Information: Name NJ Attorney ID Number Address Telephone Number Superior Court of New Jersey Law Division County Civil Part IN RE THE APPOINTMENT OF AN ATTORNEY -TRUSTEE TO PROTECT THE INTERESTS OF CL IENTS OF AN ATTORNEY AT LAW OF THE STATE OF NEW JERSEY Docket No Civil Action Verified Petition for Appointment of 1. I am an Attorney - at - Law in the State of New Jersey. I maintain offices for the practice of law at . I am fully aware of the facts set forth in this petition. 2. is/was an Attorney - at - Law in the State of New Jersey. He /she was admitted to the Bar in . He /she maintained an office for the practice of law at . 3. State present status of attorney, e.g. hospitalized, dead; disbarred; transferred to disability - inactive status; abandoned the law practice; cannot be located. He/she has no partner, shareholder, executor, administrator or other responsible party capable of conducting his law pra ctice. Supply documentation supporting the status or how the status is known to you. 4. I believe I am able to effectively and efficiently close out the practice because (state why you believe this, e.g. , familiarity with the types of cases, discussions with the disabled attorney). 5. In order for me to sign Trust Account checks to conclude pending matters and to sign business account checks for office obligations, I am applying to be appointed attorney -trustee. 6. I certify that the foregoing statement s made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment. Date Petitioner222s Signature Type or Print Petitioner 222s Name Revised 11/01/2013, CN 11407-English Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com