UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF OKLAHOMA ) ) ) ) ) ) ) ) ) ) _________________________________________________ _________________________________________________ vs. Plaintiff(s) Case No. ________________ _________________________________________________ _________________________________________________ Defendant(s) APPLICATION FOR ADMISSION PRO HAC VICE I hereby request admission to the Bar of this Court PRO HAC VICE in support of which I represent that the answers to the following questions are complete, true and correct: 1. 2. 3. Full name: ________________________________________________________________________ State bar membership number: ________________________________________________________ Business address, telephone and fax numbers: ____________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ List all state and federal courts or bar associations in which you are a member "in good standing" to practice law: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 5. Have you been denied admission, disbarred, suspended from practice, reprimanded, denied "in good standing" status, or otherwise disciplined by any court, bar association, grievance committee or administrative body? Have any proceedings which could lead to any such disciplinary action been instituted against you in any such bodies? (Please attach a statement explaining any "YES" answers to questions 5 or 6.) Are you familiar with the Federal Rules of Evidence, the Federal Rules of Civil or Criminal Procedure (as applicable to this case) and the local rules of this court? A check for $50 should be made payable to the Clerk, U.S. District Court. (Government Attorneys are exempted from paying this fee) DATED this ________ day of ___________________________, 20___. __________________________________________ 4. Yes No 6. Yes No 7. Yes No Signature of Applicant American LegalNet, Inc. www.FormsWorkFlow.com