CJA Panel Application Form. This is a Texas form and can be use in District Court Federal.
Tags: CJA Panel Application, Texas Federal, District Court
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF TEXAS CJA PANEL APPLICATION A Panel - certified criminal law specialists and other highly experienced criminal and civil lawyers who seek CJA appointments regularly. B Panel - specialists and experienced counsel who seek less frequent appointments. A Panel lawyers will receive both institutional support and an adequate number of appointments to make participation worthwhile. B Panel lawyers will have assurance of less frequent appointments, but will still enjoy continuing institutional support from the federal defender’s office. Terms of A and B panel attorneys may be limited in duration when necessary to accommodate new applicants. A&B Panel attorneys must be admitted to practice in this court and be current on annual bar membership fees. NAME: ______________________________________________________________________ BAR NUMBER: ___________________________ SSN: ________________________ EMAIL ADDRESS: ____________________________________________________________ ADDRESS: ___________________________________________________________________ _________________________________________________________________ 1. ________________________ ________________ _____________________ ________________________ ________________ _____________________ 3. Date Admitted _____________________ 2. I am a member in good standing the the following courts: Name of Court Location ________________________ ________________ Please indicate the number of lawyers who practice in your firm. Sole practitioner ( ) 2-4 member ( ) 5 or more members ( ) Have you ever been disciplined by the bar of any state or any court? Yes ( ) No ( ) If so, please explain. ______________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com 4. Please describe your professional experience generally and then specify three or four significant courtroom and/or appellate experiences you have had. A. General description of professional experience: __________________________ ________________________________________________________________ ________________________________________________________________ B. Specific significant courtroom and/pr appellate experiences: Date, Court & Type of Case Description of Experience ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 5. I read _________, write __________, speak __________and/or understand _________ ______________________________________________________________________ 6. Have you ever been employed as a full-time prosecutor, public defender, or law clerk to a judge or justice? Yes ( ) No ( ). If so, name the office of judge and dates of employment. _______________________________________________________________________ 7. During the five (5) years preceding this form, have you been arrested, summoned, charge or convicted of any criminal offense (excluding minor traffic infractions)? Yes ( ) No ( ) If so, explain: ______________________________________________________________________ 8. Please list name and address of at least two attorneys or judges familiar with your professional competence. Name Address _____________________________________________________________________ _____________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com 9. Are you willing to accept appointments in complex cases? Yes ( 10. I prefer to be a member of the: A Panel ( ) B Panel ( ) ) No ( ) (check one) I hereby authorize all educational institutions, government agencies and instrumentalities (including bar associations and bar examiners of other jurisdictions), employees and business and professional associates (past and present), to release to the Panel Selection Committee of the United States District Court for the Eastern District of Texas, any non-privileged information, files or records requested by them for the purpose of processing this form. I further state under penalty of perjury that I have carefully read the foregoing form and certify that the information therein is true to the best of my knowledge and belief. I fully understand that failure to make a truthful disclosure of any fact or item of information required may result in such action as the court deems appropriate. Executed on ___________________________ at ___________________, _______________, (Date) (City) (State) _______________________________________ Signature American LegalNet, Inc. www.FormsWorkflow.com