UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS AUSTIN DIVISION -vs- Case No.: MOTION FOR ADMISSION PRO HAC VICE TO THE HONORABLE JUDGE OF SAID COURT: Comes now ________________________________________, applicant herein, and moves this Court to grant admission to the United States District Court for the Western District of Texas pro hac vice to represent ________________________________ in this case, and would respectfully show the Court as follows: 1. Applicant is an attorney and a member of the law firm (or practices under the name of) _________________________________________________________________________, with offices at Mailing address: City, State, Zip Code: Telephone: Facsimile: ________________________________________________ ___________________________________________ ________________________________________________ ________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com 2. Since _______________________, Applicant has been and presently is a member of and in good standing with the Bar of the State of _______________________________. Applicant's bar license number is _______________________. 3. Applicant has been admitted to practice before the following courts: Court: ______________________________ ______________________________ ______________________________ ______________________________ Admission date: ______________________________ ______________________________ ______________________________ ______________________________ 4. Applicant is presently a member in good standing of the bars of the courts listed above, except as provided below (list any court named in the preceding paragraph before which Applicant is no longer admitted to practice): ________________________________________________________________________ ________________________________________________________________________ 5. Applicant has never been subject to grievance proceedings or involuntary removal proceedings while a member of the bar of any state or federal court, except as provided below: ________________________________________________________________________ ________________________________________________________________________ 6. Applicant has not been charged, arrested, or convicted of a criminal offense or offenses, except as provided below (omit minor traffic offenses): ________________________________________________________________________ -2- American LegalNet, Inc. www.FormsWorkFlow.com 7. Applicant has read and is familiar with the Local Rules of the Western District of Texas and will comply with the standards of practice set out therein. 8. Select one: G Applicant has on file an application for admission to practice before the United States District Court for the Western District of Texas. G Applicant has co-counsel in this case who is admitted to practice before the United States District Court for the Western District of Texas. Co-counsel: Mailing address: City, State, Zip Code: Telephone: ________________________________________________ ________________________________________________ ___________________________________________ ________________________________________________ 9. Should the Court grant applicant's motion, Applicant shall tender the amount of $100.00 pro hac vice fee in compliance with Local Court Rule AT-1(f)(1) [checks made payable to: Clerk, U.S. District Court]. 10. Should the Court grant applicant's motion, Applicant shall register as a filing user within 10 days of this order, pursuant to Administrative Policies and Procedures for Electronic Filing in Civil and Criminal Cases in the Western District of Texas. -3- American LegalNet, Inc. www.FormsWorkFlow.com Wherefore, Applicant prays that this Court enter an order permitting the admission of _________________________________________ to the Western District of Texas pro hac vice for this case only. Respectfully submitted, __________________________________________ [printed name of Applicant] __________________________________________ [signature of Applicant] CERTIFICATE OF SERVICE I hereby certify that I have served a true and correct copy of this motion upon each attorney of record and the original upon the Clerk of Court on this the ______ day of _________________________, ___________. __________________________________________ [printed name of Applicant] __________________________________________ [signature of Applicant] -4- American LegalNet, Inc. www.FormsWorkFlow.com IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS AUSTIN DIVISION -vs- Case No. ORDER BE IT REMEMBERED on this the ________ day of ________________, 20____, there was presented to the Court the Motion for Admission Pro Hac Vice filed by ___________________________ ("Applicant"), counsel for __________________________ and the Court, having reviewed the motion, enters the following order: IT IS ORDERED that the Motion for Admission Pro Hac Vice is GRANTED, and Applicant may appear on behalf of _____________________________ in the above case. IT IS FURTHER ORDERED that Applicant, if Applicant has not already done so, shall, in compliance with Local Court Rule AT-1(f)(1), immediately tender the amount of $100.00, made payable to: Clerk, U.S. District Court. IT IS FURTHER ORDERED that Applicant, pursuant to the Administrative Policies and Procedures for Electronic Filing in Civil and Criminal cases in the Western District of Texas, shall register as a filing user within 10 days of the date of this Order. IT IS FINALLY ORDERED that Applicant's Pro Hac Vice status shall not become effective until Applicant has complied with all provisions of this Order. SIGNED this the ________ day of _____________________ 20____. _______________________________________ UNITED STATES DISTRICT JUDGE American LegalNet, Inc. www.FormsWorkFlow.com