APPLICATION, I, ____________________________________________________________, whose mailing address is: (PLEASE PRINT - FULL NAME AS YOU WANT ON CERTIFICATE) ___________________________________________________________________________________________________ (STREET ADDRESS) _________________________________________________________________________________________do hereby make (CITY, STATE, ZIP CODE) application for admission to the bar of the United States Court of Appeals for the Eighth Circuit. My personal statement showing my eligibility for membership is as follows: I am admitted to practice in the following court(s): [See FRAP 46(a)] ______________________________________________________________________________________________________ _____________________________________________________________________________________________________ OATH: 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. Subscribed and sworn to me this _________ day of ___________________, 20___ _______________________________________________ SIGNATURE OF APPLICANT _______________________________________________ Signature of Notary (or Court of Appeals Deputy Clerk) FOR NOTARY: commission expires on _______________________, 20___ MOTION: I, ___________________________________________________ a member of the bar of this Court, do hereby move (PLEASE PRINT - FULL NAME OF MOVANT) for admission of the above attorney. ___________________________________________ SIGNATURE OF MOVANT ______________________________________________________________________________________________________ APPLICANT’S NAME: (Please Print) ____________________________________________________________________________________ SOCIAL SECURITY NO.: _____________________DATE OF BIRTH: ____________________ OFFICE TELEPHONE NO.______________________ ADMISSION FEE: Admission to the bar of this Court is $190.00. Checks should be made payable to the “Clerk, U.S. Court of Appeals.” A Certificate of admission will be issued and forwarded to you. Please recheck all information requested on this form so that NO delays are experienced in processing your application. MICHAEL E. GANS, CLERK UNITED STATES COURT OF APPEALS By: _________________________________________ (Deputy Clerk) FOR CLERK’S ONLY: Admitted this ________ day of ____________________, 20 _____ ADMISSION NO. _______________________________________ UNITED STATES COURT OF APPEALS FOR THE EIGHTH CIRCUIT (Rule 46. Federal Rules of Appellate Procedure) American LegalNet, Inc. www.USCourtForms.com