FIRST JUDICIAL DISTRICT OF PENNSYLVANIA APPLICATION FOR COURT APPOINTMENT CERTIFICATION (NON-HOMICIDE) PLEASE READ AND FOLLOW ALL DIRECTIONS INCOMPLETE, ILLEGIBLE OR IMPROPERLY PREPARED APPLICATIONS WILL BE SUMMARILY REJECTED Pursuant to FJD AGB Directive No. 2 of 1997: "[A]ppointed counsel must maintain a principal office in Philadelphia County to be eligible to receive court appointments." Please read the Rule applicable to each category before answering the questions. A copy of Rule 406 is attached hereto for your convenience. Where a brief or writing sample is required, submit only one copy. Briefs will not be returned. Where a training or education program is listed, please provide the exact title, sponsor, date, location, and subject matter of the program. You must attach a copy of the certificate of attendance for the program. Applications must be filed with the Court Appointments Clerks Criminal Listings, 206 Criminal Justice Center You may remove application pages which do not relate to the categories in which you seek certification. However, no application will be considered without pages 1, 2 and 9. PLEASE TYPE OR WRITE LEGIBLY American LegalNet, Inc. www.FormsWorkFlow.com FIRST JUDICIAL DISTRICT OF PENNSYLVANIA APPLICATION FOR COURT APPOINTMENT CERTIFICATION (NON-HOMICIDE) PLEASE TYPE OR WRITE LEGIBLY NAME ___________________________ PRINCIPAL PHILADELPHIA OFFICE __________________________________ __________________________________ __________________________________ OFFICE PHONE____________________ PA ATTORNEY ID _________________ HOM E ADDRESS (optional) _________________________ __________________________________ __________________________________ HOME PHONE_____________________ SOCIAL SECURITY NO._____________ Date of Admission to: PA Bar ____________________________ Other Courts ________________________ ________________________ Please list foreign languages in which you are fluent (if any). In which category(ies) of cases do you wish to accept appointment? 1. 2. 3. 4. 5. 6. Felony Misdemeanor Non-homicide appellate Non-homicide PCRA Major felony juvenile Non-major felony juvenile ______ ______ ______ ______ ______ ______ American LegalNet, Inc. www.FormsWorkFlow.com Please answer the following questions: 1. Are you familiar with the following (Your affirmative answer to this question is a verification that you have read the applicable rules): Pennsylvania Rules of Criminal Procedure Pennsylvania Rules of Appellate Procedure Philadelphia Court Rules -- Common Pleas (Criminal Division) Philadelphia Court Rules -- M unicipal Court (Criminal Division) Please indicate the basis of that familiarity. ______ ______ ______ ______ 2. Are you readily available to accept appointments in the category(ies) in which you are seeking certification? 3. (a) Have you ever been suspended, disbarred, or placed on inactive status in any jurisdiction? Are you an inactive Pennsylvania Practitioner, or not in compliance with the Pennsylvania Supreme Court's Continuing Legal Education requirements? Do you have any disciplinary complaints pending against you in any jurisdiction? (b) (c) If you answered "Yes" to any of the above, please provide a detailed explanation. -2- American LegalNet, Inc. www.FormsWorkFlow.com I. FELONY (Rule 406-6) Note: Attorneys who qualify for felony appointments are automatically qualified for and are obligated to take post-trial felony appointments. 1. If you are seeking appointment in felony cases, are you an active practitioner with at least two (2) years criminal litigation experience? 2. If you are seeking appointment to felony cases, please list five (5) criminal trials tried to verdict in which you were counsel (No motions or juvenile hearings). Defendant Name 1 2 3 4 5 For any of the foregoing cases which were not tried in Philadelphia County, provide a brief discussion of the nature of the case and the issues presented. Attach and additional page if necessary. 3(a) List at least two (2) adult felony cases tried to verdict within the past two years, where you were sole or lead counsel. Defendant Name 1 2 Case Number Lead Charge Trial Judge Trial Date Result Case Number Lead Charge Trial Judge Trial Date Result For any of the foregoing cases which were not tried in Philadelphia County, provide a brief discussion of the nature of the case and the issues presented. -3- American LegalNet, Inc. www.FormsWorkFlow.com 4(b) As an alternative to 4(a), indicate when and where you attended a Continuing Legal Education program in the field of felony criminal law within the past year. (Attach proof of attendance) II. MISDEMEANOR (Rule 406-7) 5. If you are seeking appointments in misdemeanor trial cases, please list when and where you attended or viewed a videotape program on Municipal Court criminal practice in the past year. In the alternative, please indicate the basis of your experience in Municipal Court cases. (Attach additional sheets if necessary). Course (Attach proof of attendance): Experience: 6. Are you familiar with Pennsylvania Rules of Criminal Procedure 1000-1013? (Your affirmative answer to this question is a verification that you have read the applicable rules). Please indicate the basis of that familiarity. III. NON-HOMICIDE APPELLATE (Rule 406-8) Note: If you have applied and qualified for felony cases, you are automatically certified in this category (see Rule 406-6). Alternatively, if you have not so qualified, please answer the following questions. 7. Submit with this application at least one (1) recent criminal case brief or writing sample written primarily by yourself which best demonstrates your excellence in written legal advocacy. (List caption) -4- American LegalNet, Inc. www.FormsWorkFlow.com 8. Please list three (3) criminal cases in which you filed briefs with the Pennsylvania Superior or Supreme Courts. Defendant 1 2 3 Docket Number Court Lead Charge Decision Citation Issues For any of the foregoing cases which were not heard in state or federal courts in Pennsylvania, provide a brief discussion of the nature of the case and the issues presented. Alternatively, indicate when and where you attended a Continuing Education Program in Pennsylvania appellate practice within the past year. Alternatively, please indicate what is the basis of your appellate experience and knowledge of Pennsylvania appellate practice qualifying you to represent appellants in criminal cases. (Attach additional sheets if necessary). Alternative 1: (Course --