"Member Request Form" - North Carolina

Member Request Form is a legal document that was released by the North Carolina State Bar - a government authority operating within North Carolina.

Form Details:

  • The latest edition currently provided by the North Carolina State Bar;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the North Carolina State Bar.

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Member Request Form
Attorney Name ________________________________ Bar # ____________________
Please indicate how many documents you are requesting and send the appropriate fee – check or
money order only (made payable to the NC State Bar); no cash or credit card payments accepted.
_____ Certificate* of Good Standing: $5.00 per certificate.
_____ Letter** of Good Standing: No charge. (At your request this document can be e-mailed.)
_____ Discipline History Letter: No charge. (Attorney signature required below.)
_____ Bar Application Copy: $30.00 per copy of each application. (Bar applications are not public
record and can only be released to the requesting attorney.)
_____ Bar ID Card: One Bar ID Card can be issued per attorney request at no charge.
A second Bar ID Card requested within a 12 month period will be a charge of $10.00.
Address where document(s) should be mailed:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
(e-mail address)
I, _______________________________, hereby authorize and request the Disciplinary Hearing Clerk
(print attorney name)
of the NC State Bar to furnish to the above named party any and all information regarding charges or
complaints filed against me, formal or informal, pending or closed, including those items which have
been dismissed or otherwise erased or expunged by law.
_____________________________________________
Signature of Attorney
Return this form and payment to the below
Use physical address for FedEx / UPS:
address:
NC State Bar
NC State Bar
Membership Department
PO Box 26088
217 E. Edenton Street
Raleigh, NC 27611
Raleigh, NC 27601
Certificates and discipline letters are typically mailed within one to two days of being received in our
office. For rush return on a certificate please provide a pre-paid overnight return envelope.
Bar files are stored off-site, please allow 2-3 weeks for bar application copies.
* A Certificate of Good Standing is signed by the Executive Director of the NC State Bar, has the NC
State Bar seal, and is printed on bond paper.
** A Letter of Good Standing states the same information as a certificate; however, is signed by a
membership representative, has no seal, and is on regular paper.
Office use only:
Request received ______________ Document(s) issued ______________
Approvals: MEM _______ CLE _______ GRV _______
Member Request Form
Attorney Name ________________________________ Bar # ____________________
Please indicate how many documents you are requesting and send the appropriate fee – check or
money order only (made payable to the NC State Bar); no cash or credit card payments accepted.
_____ Certificate* of Good Standing: $5.00 per certificate.
_____ Letter** of Good Standing: No charge. (At your request this document can be e-mailed.)
_____ Discipline History Letter: No charge. (Attorney signature required below.)
_____ Bar Application Copy: $30.00 per copy of each application. (Bar applications are not public
record and can only be released to the requesting attorney.)
_____ Bar ID Card: One Bar ID Card can be issued per attorney request at no charge.
A second Bar ID Card requested within a 12 month period will be a charge of $10.00.
Address where document(s) should be mailed:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
(e-mail address)
I, _______________________________, hereby authorize and request the Disciplinary Hearing Clerk
(print attorney name)
of the NC State Bar to furnish to the above named party any and all information regarding charges or
complaints filed against me, formal or informal, pending or closed, including those items which have
been dismissed or otherwise erased or expunged by law.
_____________________________________________
Signature of Attorney
Return this form and payment to the below
Use physical address for FedEx / UPS:
address:
NC State Bar
NC State Bar
Membership Department
PO Box 26088
217 E. Edenton Street
Raleigh, NC 27611
Raleigh, NC 27601
Certificates and discipline letters are typically mailed within one to two days of being received in our
office. For rush return on a certificate please provide a pre-paid overnight return envelope.
Bar files are stored off-site, please allow 2-3 weeks for bar application copies.
* A Certificate of Good Standing is signed by the Executive Director of the NC State Bar, has the NC
State Bar seal, and is printed on bond paper.
** A Letter of Good Standing states the same information as a certificate; however, is signed by a
membership representative, has no seal, and is on regular paper.
Office use only:
Request received ______________ Document(s) issued ______________
Approvals: MEM _______ CLE _______ GRV _______