Michigan > Statewide > Case Evaluation
Case Evaluator Application MC 34 - Michigan
| Case Evaluator Application Form. This is a Michigan form and can be used in Case Evaluation Statewide . |
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Approved, SCAO CASE EVALUATOR APPLICATION To serve as a case evaluator, you must meet the following qualifications : You must have been a practicing lawyer for at least 5 years. You must be a member in good standing of the State Bar of Michigan. You must reside, maintain an office, or have an active practice in the j urisdiction for which the list of case evaluators will be compiled. You must demonstrate that a substantial portion of your practice for the last 5 years has been devoted to civil litigation matters including investigation, discovery, motion practice, case evaluation, se ttlement, trial preparation, and/or trial. If the court maintains sublists for specific types of cases (such as pr ofessional malpractice, commercial, labor and employment), you must have had an active practice in those areas. For further inform ation, refer to MCR 2.404. Please type of print neatly. 1. Full name (first, middle initial, last) 2. Bar no. P 3. Residence address 4. Home telephone no. 5. Business address (if different from residence address) 6. Business telephone no. 7. Current employers name 8. Number of years with employer 9. Previous employers name 10. Number of years with employer 11 . Fax no. 21 . Date admitted to State Bar 31 . in Years practice Part A: General Information 14. Is this a new application? renewal? 15. Are you currently a member in good standing of the State Bar of Michigan ? Yes No16. Have you ever been disciplined by the Michigan Attorney Discipline Board or any other state or federal agency or court? If yes, explain. Complete on separate pages if needed. Yes No17. Provide information that demonstrates experience in civil litigation inc luding investigation, discovery, motion practice, case evaluation, settlement, trial preparation, and/or trial for the last 5 y ears. For any trial experience, include the name of the case, the year of trial, the case number, the number of trial days, the name o f the court, the name of the judge, and whether you represented the plaintiff or the defendant. Complete on separate pages if needed. MC 34 (3/02) CASE EVALUATOR APPLICATION, Page 1 of 3 MCR 2.404<<<<<<<<<********>>>>>>>>>>>>> 2Case Evaluator Application, continued from page 1 18. Indicate the percent of your law practice for the past 5 years devoted to civil litigation matters, including investigation, discovery, motion practice, case evaluation, settlement, trial preparation, and/or trial. _____ % plaintiff _____ %defense Indicate the percent of your current trial practice in the following areas: Personal injury/Auto negligence _____ % plaintiff _____ % defense Professional malpractice _____ % plaintiff _____ % defense Product liability _____ % plaintiff _____ % defense Commercial _____ % plaintiff _____ % defense Labor and Employment _____ % plaintiff _____ % defense Condemnation _____ % plaintiff _____ % defense Other _______________________ _____ % plaintiff _____ % defense specify Other _______________________ _____ % plaintiff _____ % defense specify Domestic relations _____ % Part B: For Specialized Lists Complete Part B if the court maintains sublists for specific types of cases and you have hadan active practice in those areas for at least the last 3 years. 19. Indicate which you primarily represent: Plaintiff Defendant Neutral (not representing a majority of either) Indicate the sublist(s) you are applying for: 20. List the areas of law in which you practice and how long you have practiced in each area. / Area of law Years practiced Area of law Years practiced / Area of law Years practiced Area of law Years practicedPart C: Additional Information 21. Provide any additional information about you which would be helpful in describing your qualifications to serve as a case evaluator, for example, teaching law school courses. Complete on separate pages if needed. I certify that I meet the requirements for service under the courts selection plan, and that I will not discriminate against parties, attorneys,or other case evaluators on the basis of race, ethnic origin, gender, or other protected personal characteristics. Date Signature MC 34 (3/02) CASE EVALUATOR APPLICATION, Page 2 of 3 MCR 2.404<<<<<<<<<********>>>>>>>>>>>>> 3Case Evaluator Application - gender and race information to be maintained separately from pages 1 and 2 of application Part D: Gender and Race Information Providing the following information is optional. It is requested in accordance with MCR 2.404(B)(1) and will be maintained separatelyfrom your application. Full name (first, middle initial, last) (print or type) Bar no. P Check the boxes that apply to you. Gender: Female Male Race/Ethnicity: American Indian or Alaskan Native Asian or Pacific Islander Black/African American (non-Hispanic) Hispanic White/Caucasian (non-Hispanic) Other MC 34 (3/02) CASE EVALUATOR APPLICATION, Page 3 of 3 MCR 2.404
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