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Application And Oath For Admission Form. This is a Official Federal Forms form and can be use in 5th Circuit Court Of Appeals Circuit Court Of Appeals.
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APPLICATION AND OATH FOR ADMISSION
U. S. COURT OF APPEALS FOR THE FIFTH CIRCUIT, 600 S. Maestri Place, New Orleans, LA 70130
PERSONAL STATEMENT
Name
(Last)
(First)
(Middle)
Firm or Agency
Street Address
Suite
City & State
Phone (
Zip
)
Fax (
Social Security No.
)
Cell Phone (
E-Mail Address
)__________________________
Date of Birth
Sex:
qM
qF
List State Bars to which admitted, and State Bar Numbers
Pursuant to FED. R. APP. P. 46(a), you must be a member in good standing of a federal or state court/bar. Please attach a certificate of good standing from
a qualifying court identified below. (NOTE, a certificate of good standing is not required if you were initially admitted to a state bar or state supreme court
within 30 days of this application.)
Court
Date Admitted
Please answer the following questions.
Yes No
q q 1. Have you ever been known by any name other than the one appearing on this application? If so, attach a list of all other names used.
q q 2. Have you been disbarred, suspended from practice or received a reprimand pertaining to your conduct or fitness to practice law from any
court, department, bureau or commission of any State or the United States? Are any such proceedings or allegations pending against you?
If so, attach a detailed explanation containing dates and circumstances.
q q 3. Are you presently under investigation, or have you been a party to criminal, or civil proceedings alleging fraud, misrepresentation or other
dishonesty? If so, attach a detailed explanation.
ADMISSION FEE: The $200 admission fee is to be paid by check payable to “Clerk, United States Court.” If claiming a fee exemption under 5th
Cir. R. 46.1, mark as appropriate:
q Court Apptd.
q U.S. Counsel
q Newly Graduated Military Attorney1
CASE NUMBER in Fifth Circuit (If Any),
OATH (OR AFFIRMATION): I,
do solemnly swear (or affirm) that I will conduct myself
as an attorney and counselor of this court, uprightly and according to law; and that I will support the Constitution of the United States. I further swear (or
affirm) all responses in my personal statement, including any attachments thereto, are true and correct to the best of my knowledge, information and belief.
Signature of Applicant
Subscribed and sworn to before me a Notary Public in and for the
of
, State of
this
day of
.
Signature of Notary
MOTION: I,
a member of the Bar of this Court, move the above attorney’s admission.
(Please print or type)
Signature
Admitted this
day of
.
By
Deputy Clerk
U.S. Court of Appeals
1
Please see attached note.
DKT-5B(10/11)
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Note Regarding Newly Graduated Military Attorney Status:
In August 2008, we amended 5th CIR. R. 46.1 to allow an admission fee waiver for newly graduated lawyers admitted to practice in Louisiana,
Mississippi, and Texas; and on initial extended active duty orders for service in the Judge Advocate General’s Corps of the armed forces.
To claim an exemption please:
1)
2)
3)
4)
Mark the Newly Graduated Military Attorney box;
Provide a paper or electronic copy of your law school transcript, or other document from you school showing your
graduation date;
Provide a paper or electronic copy of your orders directing you to report for extended active duty with the Judge Advocate
General’s Corps;
Provide documentation of bar admission.
If you have questions call 504-310-7700.
Note Regarding Change in Fee Notice:
Effective November 1, 2011, the admission fee will change from $200.00 to $226.00. Your entire
application packet must be received by the Court by October 31, 2011 to pay the current fee. Thank you.
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