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STATE OF
WISCONSIN,
* Please select a court of appearance.
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Application for
Pro Hac Vice Admission
Under SCR 10.03(4)(c) or (cm)
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I declare under penalty of perjury:
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1. That I seek to appear
pro hac vice in order to represent
in the above-captioned matter;
* Please enter a name.
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2.
That I am nonresident military counsel seeking admission under SCR 10.03(4)(c)
or nonresident counsel seeking to appear for the limited purpose of participating
in a child custody proceeding pursuant to the Indian Child Welfare Act of 1978,
25 U.S.C. s. 1901, et seq., under SCR 10.03(4)(cm).
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3.
That I am admitted to practice law in the highest court(s) of the state(s)
or country(ies) of
;
* Please enter courts admitted.
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4.
That I am admitted to practice law before the court(s) of the following
federally recognized Indian tribes:
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5.
That there are no disciplinary complaints filed against me for violation
of the rules of those courts (if so, please explain)
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6.
That I am not suspended or disbarred from practice for disciplinary
reasons or reason of medical incapacity in any jurisdiction (if yes, please explain):
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7.
That I do not practice or hold out to practice law in the State of
Wisconsin
;
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8. That
I acknowledge the jurisdiction of the courts of the State of Wisconsin over my professional
conduct, and I agree to abide by the rules of the relevant division of the Circuit
Court of the State of Wisconsin, the Wisconsin Court of Appeals, the Wisconsin Supreme
Court, and the Rules of Professional Conduct for Attorneys, if I am admitted pro
hac vice;
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9.
That I have complied fully with the requirements of SCR Rule 10.03(4) applicable to me;
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10. That
I am applying for admission pro hac vice for the following reasons:
* Please enter your reasons for this application.
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I have applied for admission pro hac vice in the courts of the State of
Wisconsin
times previously in this calendar year.
* Please select a number.
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I certify that I am not required to pay a pro hac vice fee because I qualify for
an exemption from the fee under 10.03(4)(c) or (cm).
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Signature of Attorney
* Signature of Attorney is required.
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Phone Number
* Your phone number needs to be in format: XXX-XXX-XXXX
* Please enter your phone number.
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Name Printed
* Please enter your name.
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Email Address
* Please enter your email address.
* Please enter your email address in format: youremail@example.com
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Address of Principal Office
Address 1:
* Please enter your address.
& is an invalid chararcter
Address 2 (Optional):
& is an invalid chararcter
City:
* Please enter your city.
State/Province:
Zip Code:
* US Zip Code Invalid Format
* Canadian Zip Code Invalid Format
* Please enter your zip code.
Country:
* Please enter your country.
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