"Statement in Support of Br 8.4 Reinstatement" - Oregon

Statement in Support of Br 8.4 Reinstatement is a legal document that was released by the Oregon State Bar - a government authority operating within Oregon.

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  • Released on January 1, 2018;
  • The latest edition currently provided by the Oregon State Bar;
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Oregon State Bar, Regulatory Services, PO Box 231935, Tigard, OR 97281-1935
Statement in Support of BR 8.4 Reinstatement
To:
Chief Executive Officer of the Oregon State Bar
From:
____________________________________________________________ Bar # ____________________
(Name)
I, ________________________________________________________________________
, hereby declare:
(full name)
1. That I was suspended from the Oregon State Bar on ____________________________________
,
(month/day/year)
and it has been six months or less from the date of my suspension to the date of this statement;
2. That my suspension was for no reason other than failure to pay the Professional Liability Fund assessment, Client
Security Fund assessment, or annual membership fees or penalties, or failure to file an IOLTA certificate;
3. That during the period of my suspension, I have not been suspended for professional miscouduct for more than
six months or been disbarred by any court in a jurisdiction outside of Oregon;
4. That I have paid all applicable assessments, fees and penalties required by BR 8.4 and BR 8.6 of the Rules of
Procedure;
o
did
o
did not engage in ithe practice of
m 5. I hereby attest that during the period of my suspension, I
(check one)
law in Oregon or in a jurisdiction where I was not authorized by law to do so.
If you did, explain on an attached sheet.
6. That I am seeking reinstatement as an
o
active
o
inactive
o
retired
o
active pro bono member of
(check one)
the Oregon State Bar and my enrollment status at the time of my suspension was
o
active
o
inactive
(check one)
o
retired
o
active pro bono.
7. That my email address is _____________________________________________________________________
That my business address is
___________________________________________
(number and street, city, state, zip)
_________________________________________________________________________________________
That my home address is
_____________________________________________
(number and street, city, state, zip)
_________________________________________________________________________________________
That my business phone number is ____________________________________________________________
That my home phone number is ______________________________________________________________
m = attachment may be necessary
I HEREBY DECLARE THAT THE ABOVE STATEMENT IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF, AND
THAT I UNDERSTAND IT IS MADE FOR USE AS EVIDENCE IN COURT AND IS SUBJECT TO PENALTY FOR PERJURY.
Signature ___________________________________________________________ Date ______________________
PLEASE RETURN TO: Oregon State Bar, Regulatory Services, P.O. Box 231935, Tigard, OR 97281-1935
I, Helen Hierschbiel, Chief Executive Officer of the Oregon State Bar, do hereby certify that the above-named applicant for
reinstatement has met all necessary requirements for reinstatement under BR 8.4 of the Rules of Procedure and is hereby
reinstated as an o active o inactive o retired o active pro bono member of the Oregon State Bar.
Dated this _______day of ______________, 20_____.
_______________________________________
Helen Hierschbiel, Chief Executive Officer
BR 8.4 Reinstatement
Jan/2018
Page 1 of 1
Oregon State Bar, Regulatory Services, PO Box 231935, Tigard, OR 97281-1935
Statement in Support of BR 8.4 Reinstatement
To:
Chief Executive Officer of the Oregon State Bar
From:
____________________________________________________________ Bar # ____________________
(Name)
I, ________________________________________________________________________
, hereby declare:
(full name)
1. That I was suspended from the Oregon State Bar on ____________________________________
,
(month/day/year)
and it has been six months or less from the date of my suspension to the date of this statement;
2. That my suspension was for no reason other than failure to pay the Professional Liability Fund assessment, Client
Security Fund assessment, or annual membership fees or penalties, or failure to file an IOLTA certificate;
3. That during the period of my suspension, I have not been suspended for professional miscouduct for more than
six months or been disbarred by any court in a jurisdiction outside of Oregon;
4. That I have paid all applicable assessments, fees and penalties required by BR 8.4 and BR 8.6 of the Rules of
Procedure;
o
did
o
did not engage in ithe practice of
m 5. I hereby attest that during the period of my suspension, I
(check one)
law in Oregon or in a jurisdiction where I was not authorized by law to do so.
If you did, explain on an attached sheet.
6. That I am seeking reinstatement as an
o
active
o
inactive
o
retired
o
active pro bono member of
(check one)
the Oregon State Bar and my enrollment status at the time of my suspension was
o
active
o
inactive
(check one)
o
retired
o
active pro bono.
7. That my email address is _____________________________________________________________________
That my business address is
___________________________________________
(number and street, city, state, zip)
_________________________________________________________________________________________
That my home address is
_____________________________________________
(number and street, city, state, zip)
_________________________________________________________________________________________
That my business phone number is ____________________________________________________________
That my home phone number is ______________________________________________________________
m = attachment may be necessary
I HEREBY DECLARE THAT THE ABOVE STATEMENT IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF, AND
THAT I UNDERSTAND IT IS MADE FOR USE AS EVIDENCE IN COURT AND IS SUBJECT TO PENALTY FOR PERJURY.
Signature ___________________________________________________________ Date ______________________
PLEASE RETURN TO: Oregon State Bar, Regulatory Services, P.O. Box 231935, Tigard, OR 97281-1935
I, Helen Hierschbiel, Chief Executive Officer of the Oregon State Bar, do hereby certify that the above-named applicant for
reinstatement has met all necessary requirements for reinstatement under BR 8.4 of the Rules of Procedure and is hereby
reinstated as an o active o inactive o retired o active pro bono member of the Oregon State Bar.
Dated this _______day of ______________, 20_____.
_______________________________________
Helen Hierschbiel, Chief Executive Officer
BR 8.4 Reinstatement
Jan/2018
Page 1 of 1