UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON OFFICE OF THE CLERK U.S. COURTHOUSE 700 STEWART STREET, SUITE 2310 SEATTLE, WASHINGTON 98101 (206) 370-8400 WILLIAM M. MCCOOL District Court Executive Clerk of Court LORI LANDIS Chief Deputy Clerk PETITION FOR CONDITIONAL ADMISSION TO PRACTICE INSTRUCTIONS Complete and return the Petition for Conditional Admission to Practice: � � � � Form is fillable using Adobe Acrobat Reader Oath of Attorney must be notarized. Verification required by Western District of Washington Assistant US Attorney. Registration form for the Court's Electronic Case Filing (ECF) system. Submit completed Petition for Conditional Admission to Practice to: Clerk, United States District Court Western District of Washington U.S. Courthouse Attn: Attorney Admissions 700 Stewart Street, Suite 2310 Seattle, WA 98101 Once the completed packet is received, verified and processed, a Certificate of Conditional Admission will be mailed and your ECF login and password will be e-mailed. For questions, please contact the attorney admissions clerk. Dana Scarp Phone: 206-370-8862 E-mail: dana_scarp@wawd.uscourts.gov US District Court � Petition for Conditional Admission Revised: 10/25/12 Page 1 American LegalNet, Inc. www.FormsWorkFlow.com PETITION FOR CONDITIONAL ADMISSION TO PRACTICE COMES NOW ______________________________________________, a member in good standing of the bar of (include bar number and s tate) __________________________, and respectfully petitions the Court, pursuant to Local General Rule (GR) 2(c)(2), for conditional admission to practice before the Bar of this Court as an employee of the United States representing one of its agencies. In support of said petition, the Petitioner states as follows: Petitioner's residence address is: ______________________________________________________________________ ______________________________________________________________________ Petitioner's home telephone is: ____________________________________________ Petitioner's is currently employed by the United States as an Attorney for (name of agency): ______________________________________________________________ Agency Address: ________________________________________________________ ______________________________________________________________________ Agency phone number is: _________________________________________________ Agency e-mail address is: ________________________________________________ Petitioner's general and legal education are as follows: ______________________________________________________________________ US District Court � Petition for Conditional Admission Revised: 10/25/12 Page 2 American LegalNet, Inc. www.FormsWorkFlow.com From the time of Petitioner's admission to the bar of ___________________________ (as indicated above) on ________________________________ (date), Petitioner has been engaged in the practice of law at (agency name and address): ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Petitioner seeks conditional admission, pursuant to Local Rule GR 2(c)(2), as an attorney for the United States representing one of its agencies. The circumstances necessitating Petitioner's conditional admission to the Bar of this Court are as follows: ____________________________________________________________________________ Verification that Petitioner is an at torney for the United States by an Assistant United States Attorney for this District is attached. Petitioner certifies that he/she has read and is familiar with the Federal Rules of Civil and Criminal Procedure and the Local Rules of this Court. WHEREFORE, Petitioner herein respectfully petitions that he/she be conditionally admitted to practice before the Bar of the United States District Court for the Western District of Washington. US District Court � Petition for Conditional Admission Revised: 10/25/12 Page 3 American LegalNet, Inc. www.FormsWorkFlow.com OATH OF ATTORNEY I solemnly swear that I will support and defend the Constitution and t he laws of the United States of America against all enemies, foreign and domestic; that I will and faithfully discharge my duties as a layer, counselor, and proctor of this Court; and that I will maintain the respect due to the courts of this Court; and that I will maintain the respect due to the courts of justice and the maintain the respect due to the courts of justice and judicial officers and I will demean myself uprightly and accordingly to law and recognized standards of ethics of the legal profession. Petitioner herein, being first duly sworn, on oat h deposes and s ays: That he/she has read the foregoing petition and t hat the facts stated therein are true of Petitioner's own knowledge. ___________________________________ Petitioner's Signature STATE OF _______________________________) ) ss. COUNTY OF _____________________________) SUBSCRIBED and SWORN to before me this ________ day of ___________________ 20____. ___________________________________ Notary Public in and for the State of (Seal) __________________________________, residing at __________________________. US District Court � Petition for Conditional Admission Revised: 10/25/12 My commission expires _______________. Page 4 American LegalNet, Inc. www.FormsWorkFlow.com VERIFICATION OF ASSISTANT UNITED STATES ATTORNEY I, ___________________________________________________, hereby verify that I am an Assistant United States Attorney for the Western District of Washington. I verify that ___________________________________________ is an Attorney for the United States. DATED at _____________________________ , Washington this ________ day of __________________________________ , 20______ . _________________________________________ Assistant United States Attorney US District Court � Petition for Conditional Admission Revised: 10/25/12 Page 5 American LegalNet, Inc. www.FormsWorkFlow.com ATTORNEY REGISTRATION FORM FOR THE ELECTRONIC CASE FILING (ECF) SYSTEM Name: ___________________________________________ State & Bar Number: _______________ Agency Name: _______________________________________________________________________ Agency Address: ____________________________________________________________________ ___________________________________________________________________________________ Te