Form CN:11621 "Certification of Retirement - Legal Services Volunteer" - New Jersey

What Is Form CN:11621?

This is a legal form that was released by the New Jersey Lawyers’ Fund For Client Protection - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2018;
  • The latest edition provided by the New Jersey Lawyers’ Fund For Client Protection;
  • 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 CN:11621 by clicking the link below or browse more documents and templates provided by the New Jersey Lawyers’ Fund for Client Protection.

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Download Form CN:11621 "Certification of Retirement - Legal Services Volunteer" - New Jersey

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New Jersey Lawyers’ Fund for Client Protection
P.O. Box 961
Trenton, NJ 08625-0961
Certification of Retirement -
Legal Services Volunteer
For The Calendar Year
The retired exemption from payment is as defined, without alteration. We cannot grant the
exemption if the language of this certification is altered or if “January 31” is deleted and a
later date substituted.
I, _______________________________________________, Esq., of full age, say:
Print Name
1.
I am an attorney at law licensed to practice in the State of New Jersey;
2.
I hereby request exemption from payment to the New Jersey Lawyers' Fund for Client
Protection for the calendar year(s) indicated pursuant to Rule 1:28-2 because I am
“retired completely from the practice of law” in every jurisdiction. I understand that
attorneys are not exempt from payment solely by virtue of being out-of-state or exempt
from pro bono assignment;
3.
My only participation in any aspect of legal practice is by providing qualifying pro bono
service as defined by R. 1:21-11(a) for Legal Services of New Jersey and the associated
legal regional programs; for a certified organization under R. 1:21-11(b), or for an
organization otherwise approved by the Supreme Court.
4.
Other than as stated in paragraph 3, the employment in which I engage is not in any way
related to the practice of law. I do not draft or review, if any, legal documents, render
advice on the law or legal assistance, teach law, or serve in a court system in any
capacity, in any jurisdiction. This is an accurate description of my activities at least
since January 31 of the year for which exemption is sought;
5.
I understand that I have an ongoing duty to immediately inform the Fund if I no longer
qualify for the exemption granted;
6.
I understand that I will remain officially retired until I inform the Fund otherwise;
7.
I understand that it is my obligation to keep my address current with the Fund and to
respond to the Annual Attorney Registration and Billing Form.
I certify that the foregoing statements made by me are true. I am aware that if any of the
foregoing statements made by me are willfully false, I am subject to punishment.
Date:
Signature:
Revised: 05/2018, CN: 11621
page 1 of 1
Save
Print
Clear
New Jersey Lawyers’ Fund for Client Protection
P.O. Box 961
Trenton, NJ 08625-0961
Certification of Retirement -
Legal Services Volunteer
For The Calendar Year
The retired exemption from payment is as defined, without alteration. We cannot grant the
exemption if the language of this certification is altered or if “January 31” is deleted and a
later date substituted.
I, _______________________________________________, Esq., of full age, say:
Print Name
1.
I am an attorney at law licensed to practice in the State of New Jersey;
2.
I hereby request exemption from payment to the New Jersey Lawyers' Fund for Client
Protection for the calendar year(s) indicated pursuant to Rule 1:28-2 because I am
“retired completely from the practice of law” in every jurisdiction. I understand that
attorneys are not exempt from payment solely by virtue of being out-of-state or exempt
from pro bono assignment;
3.
My only participation in any aspect of legal practice is by providing qualifying pro bono
service as defined by R. 1:21-11(a) for Legal Services of New Jersey and the associated
legal regional programs; for a certified organization under R. 1:21-11(b), or for an
organization otherwise approved by the Supreme Court.
4.
Other than as stated in paragraph 3, the employment in which I engage is not in any way
related to the practice of law. I do not draft or review, if any, legal documents, render
advice on the law or legal assistance, teach law, or serve in a court system in any
capacity, in any jurisdiction. This is an accurate description of my activities at least
since January 31 of the year for which exemption is sought;
5.
I understand that I have an ongoing duty to immediately inform the Fund if I no longer
qualify for the exemption granted;
6.
I understand that I will remain officially retired until I inform the Fund otherwise;
7.
I understand that it is my obligation to keep my address current with the Fund and to
respond to the Annual Attorney Registration and Billing Form.
I certify that the foregoing statements made by me are true. I am aware that if any of the
foregoing statements made by me are willfully false, I am subject to punishment.
Date:
Signature:
Revised: 05/2018, CN: 11621
page 1 of 1