Application for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York: (06/2018) Page 1 of 2 �TOP SECTION ONLY TO BE COMPLETED BY APPLICANT: 1st Dept. 2nd Dept. 3rd Dept. 4th Dept.In the Matter of the Application of for Admission to Practice as an Attorney and Counselor-at-Law. B Applicant must submit two (2) original good moral character affirmations as part of an application for admission ( 22 NYCRR 520.12). The affirmations should be completed by reputable persons who have known applicant for not less than two years. The affirmations should not be completed by persons who also other applicants or by members of the faculty or administrative staff of any law school attended by applicant. Preferably, one affirmation should be completed by an attorney in good standing. The person completing the affirmation should return it to the applicant, who should file it with and at the same time as application for admission questionnaire. TO BE COMPLETED BY AFFIRMANT: I , , that the answers to the following questions have been written by me or under my direction; that the substance and the language have been supplied by me and not by applicant or any other person; and that both the questions and the answers have been carefully read by me, and that the several answers are true to my own knowledge, except those stated to have been made on information and belief, or which express my opinion, and as to those answers, I believe them to be true. 1. My and addresses (full mailing addresses) are as follows: American LegalNet, Inc. www.FormsWorkFlow.com Application for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York: (06/2018) Page 2 of 2 2. To be completed only by affirmants who are attorneys. I am currently admitted to practice and in good standing inthe following jurisdiction(s) and was so admitted on the following dates: 3. In answer to this question, affirmants should provide the following: acquaintance with applicant; practice law; any other information or facts which affirmant believes would whether affirmant recommendsapplicant for admission to the New York State Bar. I affirm under the penalties of perjury under the laws of New York, with the knowledge that false statements made herein are punishable under section 210.45 of the Penal Law, which may include a fine or imprisonment that the foregoing is true and accurate to the best of my knowledge, and I understand that this document will be filed with Signature of Affirmant Dated American LegalNet, Inc. www.FormsWorkFlow.com