Connecticut > Statewide > Grievance
Attorney Registration Change Of Information JD-GC-10 - Connecticut
| Attorney Registration Change Of Information Form. This is a Connecticut form and can be used in Grievance Statewide . |
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ATTORNEY REGISTRATION CHANGE OF INFORMATION JD-GC-10 Rev. 1-12 P.B. ยง 2-27 STATE OF CONNECTICUT JUDICIAL BRANCH STATEWIDE GRIEVANCE COMMITTEE 287 Main Street, 2nd Floor, Suite 2 East Hartford, CT 06118-1885 FOR QUESTIONS, EMAIL Attorney.registration@jud.ct.gov Or call (860) 568-5157 www.jud.ct.gov/sgc Read the accompanying instructions before preparing this document. Questions about completing this form may be e-mailed to Attorney.Registration@jud.ct.gov OR call (860) 568-5157 Enter All Previously Registered Public Information Here 1. Name of Attorney Enter New or Corrected Public Information Here 1. Name of Attorney (Include proof of name change) Firm or business name (Primary law or business office) Firm or business name (Primary law or business office) Office address (Number and street) Post Office box Office address (Number and street) Post Office box City State Zip code City State Zip code Judicial District(s) of law office(s) (For Attorney with Connecticut addresses only) Judicial District(s) of law office(s) (For Attorney with Connecticut addresses only) Business telephone (Leave telephone number blank if at least one of the following boxes has been checked) Business telephone (Leave telephone number blank if at least one of the following boxes has been checked) I do not maintain a business telephone Juris number I do not work in the U.S. or its territories I do not maintain a business telephone Juris number I do not work in the U.S. or its territories 2. The following is a list of all other jurisdictions (States and District of Columbia only) where I have ever been admitted to practice as a lawyer: Year State Year State Year State 2. The following is a list of all other jurisdictions (States and District of Columbia only) where I have ever been admitted to practice as a lawyer: Year State Year State Year State None 3. I engage in the private practice of law in the State of Connecticut. Yes Not at all Retired None 3. I engage in the private practice of law in the State of Connecticut. Yes Not at all Retired Pro Hac Vice (Stop here and sign at bottom) 4. I, individually or through the firm with which I am associated, participate in IOLTA (Interest on Lawyer's Trust Accounts) pursuant to Rule 1.15 of the Rules of Professional Conduct: Yes No ("X" here ) Pro Hac Vice (Stop here and sign at bottom) 4. I, individually or through the firm with which I am associated, participate in IOLTA (Interest on Lawyer's Trust Accounts) pursuant to Rule 1.15 of the Rules of Professional Conduct: Yes No ("X" here ) 5. I do not maintain a fiduciary account. 6. Home address (Number, street, city, state, zip code) 5. I do not maintain a fiduciary account. 6. Home address (Number, street, city, state, zip code) Enter All Previously Registered Non-Public Information Here Enter New or Corrected Non-Public Information Here Office e-mail address Office e-mail address Date of birth (Month, day, year) Date of birth (Month, day, year) Certification I certify that the information provided is true. If any statements are willfully false, I realize I am subject to discipline by the Superior Court. Attorney's signature Date signed X Retain a copy for your records and mail original to: STATEWIDE GRIEVANCE COMMITTEE, ATTORNEY REGISTRATION 2nd Floor, Suite Two 287 Main Street East Hartford, CT 06118-1885. American LegalNet, Inc. www.FormsWorkFlow.com 1. Name of Attorney Juris number 7. I, individually or through the firm with which I am associated, maintain the following fiduciary account(s). (If no account is maintained leave blank; Associates and Of Counsel list firm information.) Enter All Previously Registered Information Here Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: JD-GC-10 Rev. 1-12 Enter New or Corrected Information Here Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: Account number: Financial Institution: City: New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected New Corrected American LegalNet, Inc. www.FormsWorkFlow.com Instructions for Completing the Attorney Registration Forms (JD-GC-9 and JD-GC-10) Note: Except for pro hac vice attorneys and attorneys who have been granted an exclusion from electronic services requirements, attorneys and authorized house counsel must enroll in judicial branch e-services and register electronically at www.jud.ct.gov. Excluded attorneys and pro hac vice attorneys must submit the enclosed paper form. Public Information Question 1 (Name, Address, Location of Connecticut Offices and Business Telephone) If your business address or home address is different from what is listed on the form, print clearly or type the correct information on the right side of the form. If you are currently unemployed or do not have a business address, write none in the business address section on the right side of the form. NOTE: If you register your home address in the office address section of the form it will be considered public information. In the box labeled "Judicial District(s) of Law Office(s)" enter the abbreviation of the judicial district(s) in which you or your firm maintain your law office(s). See abbreviations below. If your registration form indicates that your Judicial District Law Office is in HNB (i.e. Hartford-New Britain), please indica
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