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Application For Additional Three-Year Term On CJA Panel Form. This is a New York form and can be use in District Court Federal.
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Tags: Application For Additional Three-Year Term On CJA Panel, New York Federal, District Court
APPLICATION FOR AN ADDITIONAL
THREE-YEAR TERM ON THE CJA PANEL
FOR THE EASTERN DISTRICT OF NEW YORK
(Please attach any other information that you deem relevant.)
(Please type or print)
NAME____________________________________OFFICE TELEPHONE__________________
FIRM NAME___________________________________________________________________
OFFICE ADDRESS_____________________________________________________________
FAX NO.________________________E-MAIL ADDRESS________________________________
RESIDENCE ADDRESS____________________________________________________________
YEAR APPOINTED TO CJA PANEL, EDNY________________________________________
1)
PLEASE LIST ANY CRIMINAL CASES YOU HAVE BEEN ASSIGNED FROM THE
CJA PANEL DURING THE PAST THREE YEARS.
______________________________________________________________________________
_______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2)
HAVE YOU BEEN UNABLE TO ACCEPT ANY PANEL ASSIGNMENT OR ANY “ON
CALL” DUTY DAYS WITHIN THE LAST THREE YEARS? IF SO, PLEASE EXPLAIN
COMPLETELY.
YES_____ NO_____
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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3)
HOW MANY FEDERAL CRIMINAL CASES HAVE YOU HANDLED DURING THE
LAST THREE YEARS (INCLUDING RETAINED CASES)?_______________________
OF THAT NUMBER, HOW MANY WERE:
i)
INVESTIGATIVE STAGE ONLY____________
ii)
PLEAS OF GUILTY_______________________
iii)
TRIALS TO VERDICT_____________________
a)
b)
iv)
JURY_____________________________
NON-JURY________________________
OTHER DISPOSITION_____________________
(INDICTMENT DISMISSED, ETC.)
4)
HOW MANY TIMES HAVE YOU BEEN RELIEVED OF A CJA PANEL ASSIGNMENT
OR IN A RETAINED CRIMINAL CASE UPON APPLICATION, OR OTHERWISE,
DURING THE LAST 5 YEARS?_____________________________________________
IF ANY INSTANCES, PLEASE EXPLAIN EACH ONE.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5)
HAS YOUR APPLICATION TO ANY ASSIGNED PANEL BEEN TURNED DOWN?
________________
IF SO, PLEASE GIVE PARTICULARS.
_______________________________________________________________________________
_______________________________________________________________________________
______________________________________________________________________________
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6)
HAVE YOU EVER BEEN REMOVED FROM ANY PANEL?_____________________
IF SO, PLEASE IDENTIFY THE PANEL, DATE OF REMOVAL, AND REASON FOR
REMOVAL.______________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
7)
HAVE YOU EVER BEEN THE SUBJECT OF A BAR DISCIPLINARY PROCEEDING,
OR ARE ANY DISCIPLINARY MATTERS INVOLVING YOU PENDING?__________
IF SO, PLEASE GIVE PARTICULARS.
______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
8)
HAVE YOU EVER BEEN THE SUBJECT OF A CONTEMPT PROCEEDING?_______
IF SO, GIVE PARTICULARS.
______________________________________________________________________________
_______________________________________________________________________________
______________________________________________________________________________
9)
HAVE YOU EVER BEEN CONVICTED OF A CRIME (INCLUDING MISDEMEANORS
AS WELL AS FELONIES); OR ARE THERE ANY CRIMINAL CHARGES PENDING
AGAINST YOU?_________________________
IF SO, PLEASE GIVE PARTICULARS.
______________________________________________________________________________
_______________________________________________________________________________
______________________________________________________________________________
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10)
I HEREBY AGREE TO ABIDE BY THE DECISION OF THE CRIMINAL JUSTICE ACT
COMMITTEE ON ALL MATTERS, INCLUDING REMOVAL FROM THE PANEL.
DATE__________________________
__________________________________________
APPLICANT’S SIGNATURE
___________________________________________
PRINTED NAME
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