Form JD-CL-143 "Affidavit of Attorney Seeking Permission to Appear Pro Hac Vice" - Connecticut

What Is Form JD-CL-143?

This is a legal form that was released by the Connecticut Judicial Branch - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2017;
  • The latest edition provided by the Connecticut Judicial Branch;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-CL-143 by clicking the link below or browse more documents and templates provided by the Connecticut Judicial Branch.

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Download Form JD-CL-143 "Affidavit of Attorney Seeking Permission to Appear Pro Hac Vice" - Connecticut

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AFFIDAVIT OF ATTORNEY SEEKING
STATE OF CONNECTICUT
PERMISSION TO APPEAR PRO HAC VICE
SUPERIOR COURT
JD-CL-143 Rev. 5-17
www.jud.ct.gov
P.B. 2-16
Instructions
Complete Affidavit and deliver to Connecticut attorney making application on your behalf.
Court Information:
Judicial district
Address of court
If Application is for a Court Case:
Name of case
Docket number
If Application is for a proceeding before a State or Municipal Agency, Commission, Board, or Tribunal:
Name of out-of-state attorney
In Re Pro Hac Vice Application
Name of agency, commission, board or tribunal
Case number
Affidavit:
I,
, being duly sworn, do depose and say:
I am over the age of 18 and believe in the duties and obligations of an oath.
I make this Affidavit in support of an Application to appear pro hac vice before (name of court, agency, commission, board,
or tribunal)
for a proceeding regarding (client name)
I have a law office located at (include firm name, if applicable):
I am a member in good standing of the bar(s) of:
I certify that:
There is no grievance pending against me in any jurisdiction, nor have I ever been reprimanded,
suspended, placed on inactive status, disbarred or otherwise disciplined, nor have I ever resigned from
the practice of law in any jurisdiction.
There is a grievance pending against me, or I have been disciplined as follows (explain):
I have paid the Client Security Fund Fee due for June of
, the calendar year in which the application is made.
I hereby designate the Chief Clerk for the Judicial District of
as my agent
upon whom process and service of notice may be served.
I agree to register with the Statewide Grievance Committee in accordance with the provisions of Chapter 2 of the
Connecticut Rules of Practice while appearing in the matter in this State and for two years after the completion of the
matter in which I have appeared pro hac vice and will notify the Statewide Grievance Committee of the expiration of the
two year period.
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AFFIDAVIT OF ATTORNEY SEEKING
STATE OF CONNECTICUT
PERMISSION TO APPEAR PRO HAC VICE
SUPERIOR COURT
JD-CL-143 Rev. 5-17
www.jud.ct.gov
P.B. 2-16
Instructions
Complete Affidavit and deliver to Connecticut attorney making application on your behalf.
Court Information:
Judicial district
Address of court
If Application is for a Court Case:
Name of case
Docket number
If Application is for a proceeding before a State or Municipal Agency, Commission, Board, or Tribunal:
Name of out-of-state attorney
In Re Pro Hac Vice Application
Name of agency, commission, board or tribunal
Case number
Affidavit:
I,
, being duly sworn, do depose and say:
I am over the age of 18 and believe in the duties and obligations of an oath.
I make this Affidavit in support of an Application to appear pro hac vice before (name of court, agency, commission, board,
or tribunal)
for a proceeding regarding (client name)
I have a law office located at (include firm name, if applicable):
I am a member in good standing of the bar(s) of:
I certify that:
There is no grievance pending against me in any jurisdiction, nor have I ever been reprimanded,
suspended, placed on inactive status, disbarred or otherwise disciplined, nor have I ever resigned from
the practice of law in any jurisdiction.
There is a grievance pending against me, or I have been disciplined as follows (explain):
I have paid the Client Security Fund Fee due for June of
, the calendar year in which the application is made.
I hereby designate the Chief Clerk for the Judicial District of
as my agent
upon whom process and service of notice may be served.
I agree to register with the Statewide Grievance Committee in accordance with the provisions of Chapter 2 of the
Connecticut Rules of Practice while appearing in the matter in this State and for two years after the completion of the
matter in which I have appeared pro hac vice and will notify the Statewide Grievance Committee of the expiration of the
two year period.
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I have appeared
times pro hac vice in the superior court or in any other proceedings in the State of
Connecticut since I first appeared pro hac vice in this state; the case names and docket numbers of those proceedings are:
I have previously been assigned Juris Number
as a pro hac vice attorney in Connecticut.
I understand that, unless excused by the judicial authority, Connecticut Attorney
,
who submitted the Application on my behalf, must be present at all proceedings, including depositions in a proceeding, and
must sign all pleadings, briefs and other papers filed with the court, agency, commission, board, or tribunal named above,
and assume full responsibility for them and for the conduct of the cause or proceeding and of this Affiant.
Good Cause exists to permit me to represent the client named in this Affidavit in the proceeding before the above named
court, agency, commission, board, or tribunal.
(Describe the facts or circumstances affecting the personal or financial welfare of the client that establish “good cause”):
Print name
Date signed
Signed (Out-of-State Attorney/Affiant)
Date signed
Signed (Commissioner of Superior Court/Notary Public)
Subscribed and sworn to before me:
ADA NOTICE
The
Judicial
Branch
of
the
State
of
Connecticut complies with the Americans with
Disabilities
Act
(ADA).
If
you
need
a
reasonable accommodation in accordance
with the ADA, contact a court clerk or an ADA
contact person listed at www.jud.ct.gov/ADA.
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