Print Form UNITED STATES DISTRICT COURT FOR THE DISTRICT OF UTAH ATTORNEY REGISTRATION FORM 2007 - 2008 Name: ___________________________________________ Bar ID: _______________ Office: ___________________________________________ Telephone: ___________________ Address 1: ________________________________________ Address 2: ________________________________________ City, State Zip ______________________________________ Email: ________________________________________________________________________ 1. 2 REGISTRATION INSTRUCTIONS Verify the information, including bar number and email address(es), printed above; it reflects the Court's official record of how to reach you. Make corrections directly on this form. Complete the form with your original signature and mail or deliver it with a check or money order for $15 made payable to "District Court Bar Fund" or provide your credit card information below by COB July 1, 2007, to: U.S. District Court 350 S Main St, Rm 150 Salt Lake City, Utah 84101 PAYMENT MUST BE RECEIVED BY COB JULY 1, 2007, TO RETAIN ACTIVE STATUS Telephone 801-524-6100 Hours: 8:30 a.m. - 5:00 p.m., Mon.- Fri FEDERAL BAR MEMBERSHIP STATUS Please check one: Active.................................... $15.00 Active ................................... No Fee* * No fee required if admitted after July 1, 2006. Inactive.................................. No Fee Pursuant to DUCivR 83-1.2, I hereby register as a member of the Bar of the United States District Court for the District of Utah for 2007-08 (July 1, 2007 - June 30, 2008). I certify that: 1. I am a member in good standing of the Bar of this Court and of the Utah State Bar, 2. I have read and am familiar with the Rules of Practice of this court. 3. I acknowledge that the court has mandated electronic filing for all active members of its bar and will comply accordingly. ________________________________________ Signature ____________________ Date CREDIT CARD INFORMATION Name on Card:_____________________________________________________ Type of Card: ___Visa ___American Express Authorizing Signature:_______________________________________________ ___MasterCard ___Diners Club Credit Card Nbr/Exp Date:_____________________________________ /___________ ___Discover Total Amount Authorized:_________ X $15.00 = $________________________ American LegalNet, Inc. www.FormsWorkflow.com