"Application for Appearance Pro Hac Vice" - Arizona

Application for Appearance Pro Hac Vice is a legal document that was released by the State Bar of Arizona - a government authority operating within Arizona.

Form Details:

  • Released on May 1, 2020;
  • The latest edition currently provided by the State Bar of Arizona;
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  • Fill out the form in our online filing application.

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For Official Use Only
App#
Bar Number#
Attn: Pro Hac Vice Dept
Overnight or Hand Delivery:
P.O. Box 53099
4201 N. 24th St., Ste 100
Phoenix, AZ 85072-3099
Phoenix, AZ 85016-6266
Phone: 602-340-7239
Application for Appearance Pro Hac Vice
PART I: Applicant Information
Name of Applicant:
Firm/Company Name:
Office Address:
Telephone:
Fax:
Email Address:
Residence Address:
Title of cause or case where applicant seeks to appear:
Docket Number:
Court, Board, or Administrative Agency:
Party on whose behalf applicant seeks to appear:
Pursuant to Arizona Supreme Court Rule 39(a)(2), the applicant shall complete the information below:
Courts to Which Applicant Has Been Admitted:
Date of Admission:
Bar Number:
(Attach additional pages if necessary)
Applicant is a member in good standing in such courts.
Applicant is not currently dis barred or suspended in any court.
Applicant
is /
is not (select one) currently subject to any pending disciplinary proceeding or investigation by any court, agency
or organization authorized to discipline attorneys at law. If yes, specify the jurisdiction, nature of investigation and contact
information of the disciplinary authority investigating on an additional page.
In the preceding three (3) years, applicant has filed applications to appear as counsel under Ariz. R. Sup. Ct., Rule 39(a) in the
following:
Title of Matter:
Docket #:
Court or Agency:
App Granted? (Y/N)
This case or cause
is /
is not (select one) a related or consolidated matter for which applicant has previously applied to appear
pro hac vice in Arizona. If this matter is a related or consolidated with any previous application, Applicant certifies that he/she will
review and comply with appropriate rules of procedure as required in the underlying cause.
If applicable, please provide related or consolidated matter application or docket#
Revised 05/01/20
For Official Use Only
App#
Bar Number#
Attn: Pro Hac Vice Dept
Overnight or Hand Delivery:
P.O. Box 53099
4201 N. 24th St., Ste 100
Phoenix, AZ 85072-3099
Phoenix, AZ 85016-6266
Phone: 602-340-7239
Application for Appearance Pro Hac Vice
PART I: Applicant Information
Name of Applicant:
Firm/Company Name:
Office Address:
Telephone:
Fax:
Email Address:
Residence Address:
Title of cause or case where applicant seeks to appear:
Docket Number:
Court, Board, or Administrative Agency:
Party on whose behalf applicant seeks to appear:
Pursuant to Arizona Supreme Court Rule 39(a)(2), the applicant shall complete the information below:
Courts to Which Applicant Has Been Admitted:
Date of Admission:
Bar Number:
(Attach additional pages if necessary)
Applicant is a member in good standing in such courts.
Applicant is not currently dis barred or suspended in any court.
Applicant
is /
is not (select one) currently subject to any pending disciplinary proceeding or investigation by any court, agency
or organization authorized to discipline attorneys at law. If yes, specify the jurisdiction, nature of investigation and contact
information of the disciplinary authority investigating on an additional page.
In the preceding three (3) years, applicant has filed applications to appear as counsel under Ariz. R. Sup. Ct., Rule 39(a) in the
following:
Title of Matter:
Docket #:
Court or Agency:
App Granted? (Y/N)
This case or cause
is /
is not (select one) a related or consolidated matter for which applicant has previously applied to appear
pro hac vice in Arizona. If this matter is a related or consolidated with any previous application, Applicant certifies that he/she will
review and comply with appropriate rules of procedure as required in the underlying cause.
If applicable, please provide related or consolidated matter application or docket#
Revised 05/01/20
Page 2
PART II: Local Counsel Information
Name of Arizona Local Counsel:
State Bar of Arizona Number:
Address:
Telephone:
Fax:
Email Address:
Local Counsel is a member in good standing.
Local Counsel associating with a nonresident attorney in a particular cause s hall accept joint responsibility with the nonresident
attorney to the client, to opposing parties and counsel, and to court, board, or administrative agency in that particular cause.
PART III: Parties and Certification
Name(s) of each party in this cause and name and address of all counsel of record:
Party:
Counsel of Record:
Address:
Applicant is including with this application a nonrefundable application fee, payable to the State Bar of Arizona, in the
amount of $505.00. Fifteen percent of the non-refundable application fee paid pursuant to this section shall be deposited
into a civil legal services fund to be distributed by the Arizona Foundation for Legal Services and Education entirely to
approved legal services organizations, as that term is defined in subparagraph (2)(c) of this rule.
Applicant is furnishing a certificate from the state bar or from the clerk of the highest admitting court of each state, territory, or
insular possession of the United States in which the nonresident attorney has been admitted to practice law certifying the
nonresident attorney's date of admission to such jurisdiction and the current status of the nonresident attorney's membership or
eligibility to practice therein. The certificate furnished s hall be no more than forty-five (45) days old.
Applicant certifies the following:
1.
Applicant shall be subject to the jurisdiction of the courts and agencies of the State of Arizona and to the State Bar of Arizona
with respect to the law of this state governing the conduct of attorneys to the same extent as an active member of the State
Bar of Arizona, as provided in Ariz. R. Sup. Ct. Rule 46(b).
2.
Applicant will review and comply with appropriate rules of procedure as required in the underlying cause.
3.
Applicant understands and shall comply with the standards of conduct required of members of the State Bar of Arizona.
Verification
STATE OF
)
County of
) ss.
I,
, swear that all statements in the application are true, correct and complete to the
best of my knowledge and belief.
Dated:
Applicant’s Signature:
SUBSCRIBED AND SWORN TO before me this
day of
, 20
, by
.
Name of Applicant
Notary Public
Revised 05/01/20
Page of 2