UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF NEW YORK --------------------------------------------------------------x In re: Case No.: _________ Chapter ___ Debtor --------------------------------------------------------------x Adversary Proceeding No.: __________ Plaintiff v. Defendant --------------------------------------------------------------x MOTION FOR ADMISSION TO PRACTICE, PRO HAC VICE I, _________________________________, request admission, pro hac vice, before the Honorable _____________________, to represent _________________________________, a ___________________________ in the above-referenced case adversary proceeding. I certify that I am a member in good standing of the bar in the State of _____________________ and, if applicable, the bar of the U.S. District Court for the ____________ District of ____________________________. I have submitted the filing fee of $200.00 with this motion for pro hac vice admission. Dated: ______________ ____________________, New York ____________________________________ Mailing Address: ____________________________________ ____________________________________ ____________________________________ E-mail address: ______________________ Telephone number: ( ) ______________ American LegalNet, Inc. www.FormsWorkFlow.com