APPLICATION FOR PUBLICATION CREDIT CLE NEW YORK STATE CONTINUING LEGAL EDUCATION BOARD 25 Beaver Street, Room 888 • New York, New York 10004 • Phone: (212) 428-2105 • Fax: (212) 428-2974 Web site: www.nycourts.gov/attorneys/cle • E-mail: cle@courts.state.ny.us Check one: G Ms. G Mr. Name (please print or type clearly): Street/City/State/Zip: Telephone: E-mail: Date Admitted to NYS Bar: Date of Birth: Attorney Registration #: Title of legal research-based writing: Name of publication in which it was/will be published: Date published or date accepted for publication: Time spent on legal research and writing: Total number of CLE credits requested: Of the total, how many credits, if any, do you seek in Ethics and Professionalism: Have you received any other publication credit for your current CLE cycle? 9 Yes 9 No If yes, answer the questions below: Date previous legal research-based writing was published/accepted for publication: • Title: • CLE credit hours awarded: Please Note: • One (1) CLE credit may be awarded for each 50 minutes of research and writing • You may NOT earn more than 12 CLE publication credit hours during a CLE reporting cycle • Newly admitted attorneys are NOT ELIGIBLE for publication credit • Credit may be awarded for speaking at a CLE activity or for preparation of written materials for that activity, BUT NOT BOTH • Joint authors seeking credit MUST each file a separate application • Applicants not listed as authors MUST submit a letter from a listed author attesting to his/her contribution and describing its nature • Both the application and its attachments MUST be sent by regular mail. E-mail submissions will not be accepted The following do NOT qualify for CLE publication credit: • Editing legal research-based writing • Authorship of published decisions • Writing appearing in a publication for general circulation or in a publication directed to a nonlawyer audience • Legal research-based writing appearing in any publication, whether print or electronic, that is controlled by the applicant’s firm or employer You MUST include a printed copy of the complete legal research-based writing and proof of publication (or proof of acceptance for publication). All legal research-based writing not in English must be submitted with an English translation. Signature of Attorney Requesting Credit: 9 Approved Date: Date: Publication # Total number of CLE credits awarded: Of the total, credits awarded in Ethics and Professionalism: 9 W ithdrawn For Office Use Only: 9 Denied Date: Publication # 9 Newly Admitted Attorney 9 Not Legal Research-Based Writing 9 In a Publication or on a Web Site Owned or Controlled by Attorney’s Firm//Employer 9 Publication Directed to Nonlawyer Audience 9 Already received 12 Publication Credits in Current Cycle, for Publication # For Office Use Only: This application will be returned to you with the Board’s Approval or Denial indicated above. You must retain this form for at least four (4) years. American LegalNet, Inc. www.FormsWorkFlow.com June 2011