United States District Court Northern District of Ohio Statement of Sponsors I, ______________________________________ (Name) and I, _________________________________ (Name) being members of the Bar of the United States District Court for the Northern District of Ohio and not related to the applicant, state that the applicant is personally known to us, that the applicant possesses all the qualifications required for admission to the Bar of the United States District Court for the Northern District of Ohio, that we have examined this personal statement and believe it to be correct, and we affi m that the applicant's personal and professional character r and standing are good. Signed __________________________ Sponsor 1 Signed __________________________________ Sponsor 2 Firm Name Firm Name Address Address City, State, Zip City, State, Zip Telephone Number Telephone Number Email Address Email Address Northern District of Ohio Admission Date Northern District of Ohio Admission Date Highest State Court Bar I.D. Number Highest State Court Bar I.D. Number January 1, 2013 American LegalNet, Inc. www.FormsWorkFlow.com