Form PHV-17 (12543) "Pro Hac Vice Admission Form" - New Jersey

What Is Form PHV-17 (12543)?

This is a legal form that was released by the New Jersey Judiciary Court System - 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 January 1, 2020;
  • The latest edition provided by the New Jersey Judiciary Court System;
  • 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 PHV-17 (12543) by clicking the link below or browse more documents and templates provided by the New Jersey Judiciary Court System.

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Download Form PHV-17 (12543) "Pro Hac Vice Admission Form" - New Jersey

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Pro Hac Vice Admission in New Jersey
{Rules 1:21-2(a), 1:20-1(b), 1:28-2, 1:28B-1(e)}
Please submit one check for each attorney payable to NJ Lawyers’ Fund for Client Protection
Mail to: NJ Lawyers’ Fund, P.O. Box 961, Trenton, NJ 08625-0961
2020 ASSESSMENT $212.00
The fee is assessed once per calendar year per attorney. Attorneys admitted for additional cases within the
calendar year should submit the appropriate paperwork, but no additional payment is required. If a case
continues into the next year, a fee for that year will be assessed. An attorney’s appearance continues until either
the matter is concluded, there is a substitution of counsel, or the filing of notice of withdrawal with the court. Fees
are not prorated. Full payment is required for the calendar year in which the Order admitting is entered.
Information To Be Submitted With Payment
Pro Hac Vice Attorney:
Name: Last
First
Middle
Title
Date of Birth
Sex
Male
Female
Jurisdiction Where First Admitted to Any U.S. Bar
Year Admitted
Have You Ever Been Admitted in New Jersey in any of the Following Categories?
Plenary NJ License
Multi-Jurisdictional Practitioner
In-House Counsel
Foreign Legal Consultant
Firm Name
Telephone #
ext.
Address
City
State
Zip
-
e-mail
Sponsoring New Jersey Attorney:
Name: Last
First
Middle
Title
Firm Name
Telephone #
ext.
Address
City
State
Zip
-
e-mail
Enclose a copy of the signed Court Order. If it is not yet available, provide an
unsigned copy or the following information; send a signed copy when it becomes
available.
Docket #
Jurisdiction
Judge’s Name
Questions? Please contact the NJ Lawyers’ Fund’s Pro Hac Vice Unit at (609) 815-3030, Option 1
Published 01/2020, CN 12543 (PHV-17)
page 1 of 1
Save
Print
Clear
Pro Hac Vice Admission in New Jersey
{Rules 1:21-2(a), 1:20-1(b), 1:28-2, 1:28B-1(e)}
Please submit one check for each attorney payable to NJ Lawyers’ Fund for Client Protection
Mail to: NJ Lawyers’ Fund, P.O. Box 961, Trenton, NJ 08625-0961
2020 ASSESSMENT $212.00
The fee is assessed once per calendar year per attorney. Attorneys admitted for additional cases within the
calendar year should submit the appropriate paperwork, but no additional payment is required. If a case
continues into the next year, a fee for that year will be assessed. An attorney’s appearance continues until either
the matter is concluded, there is a substitution of counsel, or the filing of notice of withdrawal with the court. Fees
are not prorated. Full payment is required for the calendar year in which the Order admitting is entered.
Information To Be Submitted With Payment
Pro Hac Vice Attorney:
Name: Last
First
Middle
Title
Date of Birth
Sex
Male
Female
Jurisdiction Where First Admitted to Any U.S. Bar
Year Admitted
Have You Ever Been Admitted in New Jersey in any of the Following Categories?
Plenary NJ License
Multi-Jurisdictional Practitioner
In-House Counsel
Foreign Legal Consultant
Firm Name
Telephone #
ext.
Address
City
State
Zip
-
e-mail
Sponsoring New Jersey Attorney:
Name: Last
First
Middle
Title
Firm Name
Telephone #
ext.
Address
City
State
Zip
-
e-mail
Enclose a copy of the signed Court Order. If it is not yet available, provide an
unsigned copy or the following information; send a signed copy when it becomes
available.
Docket #
Jurisdiction
Judge’s Name
Questions? Please contact the NJ Lawyers’ Fund’s Pro Hac Vice Unit at (609) 815-3030, Option 1
Published 01/2020, CN 12543 (PHV-17)
page 1 of 1