UNITED STATES DISTRICT COURT DISTRICT OF SOUTH CAROLINA (______________ DIVISION) ) ) ) v. ) ______________________________, ) Defendant/Respondent. ) _________________________________________ ) (1) (2) (3) ______________________________, Plaintiff/Petitioner/USA, Case No. ________________________ Application/Affidavit for Pro Hac Vice Admission Name. _________________________________________________________________________ First Middle Last Residence. I reside in the following state: _____________________________________________ If a South Carolina resident, indicate months/years of residence: ___________________________ Business Address. I am an attorney and practice law under the name of or as a member of the following firm: Firm name: _____________________________________________________________________ Mailing address: ________________________________City/State/Zip_____________________ Telephone number: _______________________________________________________________ Facsimile number: ________________________________________________________________ E-mail address: __________________________________________________________________ (Application will not be considered without an e-mail address to receive electronic notification.) (4) Jurisdiction of this Court. I, by execution of this Application and Affidavit, consent and agree to comply with the applicable statutes, laws, and rules of the State of South Carolina, with all applicable federal statutes, laws, and rules, including Local Rules of the United States District Court for the District of South Carolina (particularly, Local Civil Rule 83.I.08 and/or Local Criminal Rule 57.I.08). I consent to the jurisdiction of the United States District Court for the District of South Carolina in all matters of attorney conduct.1 Regular Practice of Law. I am a member in good standing of the bar of the highest court of the District of Columbia or the State of ____________________ where I regularly practice law. Attached is my certificate of good standing. Additional Bar Membership. I have been admitted to practice before the following courts: (List all of the courts Applicant has been admitted to practice before: United States District Courts; United States Circuit Courts of Appeals; the Supreme Court of the United States; and courts of other states or the District of Columbia.) By signing this Affidavit, I certify that I am a member in good standing of each of the listed bars unless otherwise noted. 1 (5) (6) This District 1 maintains a web site (www.scd.uscourts.gov) from which the federal and local rules of procedure and related materials may be obtained. American LegalNet, Inc. www.FormsWorkFlow.com Court Date Admitted _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ (7) Good Standing Yes No Yes No Yes No Pending Disciplinary Matters. Are you presently the subject of any formal suspension or disbarment proceedings, and have you been notified by any disciplinary agency of the initiation of No formal procedures? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes (If "yes," give particulars, such as jurisdiction, court, date, grounds. Information to comply with this paragraph may be provided in camera but that fact shall be revealed below.) _______________________________________________________________________________ _______________________________________________________________________________ Curtailment of Prior Pro Hac Vice Admissions. Have you ever had any application for admission pro hac vice in this or any other jurisdiction denied or any pro hac vice admission revoked? Yes No (If "yes," give particulars, such as date, court, docket number, judge, circumstances; attach a copy of any order of denial or revocation.) _______________________________________________________________________________ _______________________________________________________________________________ Sanctions. Have you ever had any certificate or privilege to appear and practice before any judicial or administrative body suspended or revoked, or received a public reprimand or greater sanction? Yes No (If "yes," give particulars, e.g., judicial or administrative body, date of suspension, and reinstatement.) _______________________________________________________________________________ _______________________________________________________________________________ Criminal Sanctions. Have you ever been convicted of a felony under the laws of the District of Columbia or of any State or under the laws of the United States? Yes No (If "yes," give particulars, such as date, court, judge, circumstances, and ultimate disposition.) _______________________________________________________________________________ _______________________________________________________________________________ Present and Previous Pro Hac Vice in this Court. Have you, within the last ten (10) years, filed an application to appear pro hac vice in the United States District Court for the District of South Carolina or another court in the state of South Carolina? Yes No (If "yes," give court, case name, docket number, and status of litigation, year of application, local counsel of record in each case, and state whether application is pending or was granted.) Attach additional pages if necessary. _______________________________________________________________________________ _______________________________________________________________________________ Designated Local Counsel. Local counsel of record associated with Applicant in this case is: Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com (8) (9) (10) (11) (12) Firm Name: Street Address or Post Office Box: City, State, and Zip Code: Telephone Number: E-Mail Address: Attorney Name: _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ ____ I understand that local counsel of record is required to: (1) personally sign each pleading, motion, discovery procedure, or other document served or filed in this Court; (2) accept service of all pleadings and notices as required on behalf of all counsel for the party represented; (3) be present at all pretrial conferences,