DISTRICT COURT JUDGE SELECTION QUESTIONNAIRE You are requested to provide the following information to the Judges of the Circuit Court for the City of Newport News. If more space is needed, you may attach additional pages. PLEASE DO NOT RETYPE THIS QUESTIONNAIRE. Your responses to these questions are only for the use of the Judges of the Circuit Court and are entitled to confidentiality under Virginia Code §2.1-342(B)(6). 1. State your full name. 2. State your office and home address, including the city or county. 3. State your office telephone number. 4. State the date and place of your birth. 5. Indicate your marital status; if married, include the full name of your spouse (including family name), the number of marriages, and the number and ages of your children. 6. Indicate any periods of military service, including the dates, branch, rank or rate, serial number, and type of discharge. 7. List each college or university an law school you attended, including the dates of attendance, the degree awarded, and the date you received your degree. If you received no degree from that institution, please indicate your reason for leaving. American LegalNet, Inc. www.FormsWorkflow.com 8. State when you were admitted to practice law in Virginia. 9. If you are admitted to practice law in other states, give the names of the states and dates of admission. 10. List all courts in which you are presently admitted to practice and give the dates of admission. Indicate the same information for any administrative bodies having special admission requirements. 11. Indicate whether you are actively engaged in the practice of law at the present time. If you are, please state the name and location of your employer. Indicate the duration of your employment relationship. 12. Please give the particulars of your prior legal employment history. Include the names and locations of your employers, as well as the relevant dates. Indicate any period in the past during which you were a solo practitioner. 13. State the general character of your current practice. Please describe your typical clients and list any legal specialties which you possess. If the nature of your practice has been substantially different at any time in the past, give details. American LegalNet, Inc. www.FormsWorkflow.com 14. (a) Indicate how often you appear in court. (b) Using percentages, describe how much of your practice consists of: criminal, tort, real estate, corporate, domestic relations, labor/employment, other (specify). (c) Using percentages, indicate your court appearances during the last five years in: federal courts, state courts of record, other courts (specify). (d) Using percentages, indicate how much of your litigation during the last five years was civil or criminal. (e) Using percentages, indicate how many of your trials during the last five years were jury or non-jury. (f) Indicate how many cases you tried to conclusion in courts of record during the last five years: ___ Less than 5 ___ 5 - 10 ___ 10 - 20 ___ 20 or more (g) Describe any experience you might have in adversary proceedings before administrative boards or commissions during the last five years. American LegalNet, Inc. www.FormsWorkflow.com 15. Indicate whether you have ever been engaged in any occupation, business, or profession other than the Practice of law. If so, please give relevant dates and details. 16. State whether you are the officer or director of any business organization, or you are otherwise engaged in the management of any business organization. If so, please give details, including the name of the organization, the nature of the business, the title of your position, the nature of your duties, and the term of your service. Please note and give reasons if you do not intend to resign such positions or relinquish participation in the management of these organizations. 17. List all civic, social, or fraternal organizations, clubs, and groups of which you are a member, officer, director, or trustee. Indicate if any of these organizations, club, or groups practice invidious discrimination on the basis of race, sex, religion, or national origin. 18. Indicate whether anyone ever instituted criminal charges against an organization during your affiliation with it as an officer, director, or manager. If so, please give details. American LegalNet, Inc. www.FormsWorkflow.com 19. State if you have ever held public office. If so, give details, including the title of office, whether you were elected or appointed, duties, and the length of service. 20. Indicate whether you have ever been arrested, charged, or held for violation of any federal law, stats law, county or municipal law, regulation, or ordinance. If so, give details. Please do not include traffic violations for which a fine of $100 or less was imposed. 21. State whether you have ever been sued by a client or former client for malpractice, breach of fiduciary duty, or other reasons. If so, give details. 22. Indicate whether you have ever been a party or otherwise involved in any other legal proceedings. Include all proceedings in which you were a party in interest, a material witness, a named co-conspirator or co-respondent, a grand jury subject, or a grand jury witness. Do not include any proceedings in which you were a nominal party and there were no allegations or wrongdoing against you. 23. State if you are currently under investigation by any court, law enforcement entity, administrative agency, bar association, disciplinary committee, or other professional group. If so, please give details. American LegalNet, Inc. www.FormsWorkflow.com 24. State if you have ever been disciplined or cited by any court, administrative agency, bar association, disciplinary committee, or other professional group. If so, please give details. 25. List any suits pending or actions threatened against you. 26. List any legal books or articles that you have published. Please give citations and dates. 27. List any honors, prizes, awards, or other forms of recognition that you have received. 28. List all bar associations and professional societies of which you are a member and give the titles and dates of any offices which you have held in such groups. Include any chairmanships and memberships of any committees in these associations and societies which you believe to be of particular significance. 29. (a) Describe your present state of health. (b) Indicate whether you have ever been hospitalized or prevented from working for more that ten days due to any condition, injury, or illness. If so, give details, including the present status of those conditions that caused the confinement or incapacitation. American LegalNet, Inc. www.FormsWorkflow.com (c) Indicate whether you have ever been treated for any emotional or mental illness. If so, give details. (d) Describe any physical limitations you might have, including an impairment of eyesight or hearing. (e) Indicate to what extent you use alcohol or drugs. 30. Indicate whether you have any prior experience as a Substitute Judge. If so, give details. 31. Provide below the names, addresses and telephone numbers of three references that can describe your reputation in the profession and community. At least one individual should be a non-lawyer and someone or some entity upon which you provided legal service. Signature American LegalNet, Inc. www.FormsWorkflow.com