LR Civ P 83.6 LR Cr P 44.6 UNITED STATES DISTRICT COURTSOUTHERN DISTRICT OF WEST VIRGINIAATSTATEMENT OF VISITING ATTORNEYAND DESIGNATION OF LOCAL COUNSELV.CASE NUMBER Name of Visiting Attorney and firm name ar ID number Name of party representedName and address of the Bar(s) of which the Visiting Attorney is a member in good standingVisiting Attorney222s office address Visiting Attorney222s office telephone numberOffice fax numberEmail address Name of Sponsoring Attorney and firm nameWV Bar ID numberSponsoring Attorney222s office address Sponsoring Attorney222s office telephone number Office fax number Email addressWV American LegalNet, Inc. www.FormsWorkFlow.com VISITING ATTORNEY222S CERTIFICATION I hereby certify that I am a member in good standing of the Bar(s) listed in the Statement ofVisiting Attorney and that I have never been convicted of a felony. I further certify that I have paidthe West Virginia State Bar its prescribed pro hac vice fee for this case, and complied with the WestVirginia State Bar222s requirements for attorneys admitted pro hac vice. Date Signature of Visiting AttorneySPONSORING ATTORNEY222S CERTIFICATION I hereby certify that I am admitted to practice before the Supreme Court of Appeals of WestVirginia, I am a member in good standing of the West Virginia State Bar, and I am a member of thebar of this Court. I further certify that I have an office for the practice of law in West Virginia, andI practice law primarily in West Virginia. I agree that pleadings, notices, and other papers maybe served on me in this case. I consent to being the Sponsoring Attorney for the above-namedVisiting Attorney and I shall hereafter sign all papers that require the signature of an attorney.DateSignature of Sponsoring Attorney ** ELECTRONIC FILING REQUIREMENT ** Electronic filing is required in the United States District Court for the Southern District of WestVirginia. Please refer to the Court's website at www.wvsd.uscourts.gov under CM/ECF Information >Electronic Filing > Administrative Procedures for Electronic Case Filing in the SDWV for guidance. Specific requirements regarding logins and passwords and the registration process may be found atSection 6. Registration. American LegalNet, Inc. www.FormsWorkFlow.com