Rhode Island > Statewide > Supreme Court > Court Appointment
Application For Court Appointment Certification - Rhode Island
| Application For Court Appointment Certification Form. This is a Rhode Island form and can be used in Court Appointment Supreme Court Statewide . |
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State of Rhode Island and Providence Plantations APPLICATION FOR COURT APPOINTMENT CERTIFICATION Attorneys seeking certification to panels for fee generating appointments must submit this application to the Chief Judge of the court of appointment. The information provided must demonstrate that the attorney has the required level of experience to qualify for appointment in the type(s) of case(s) indicated. A separate application must be submitted for each panel, unless the qualifications for the panels are overlapping. Attorney ID#:_________ Attorney Name:____________________________________________ Address:_________________________________________Phone No:_______________________ _____________________________________________________ _____________________________________________________ If payments will be made to your firm, complete the following: Firm Name: ______________________________________ Firm FIN: _____________________ COURT OF APPOINTMENT AND LOCATION : Indicate the court to which you are forwarding this application and the location(s) where you are willing to receive appointments. COURT: zz Supreme zz Superior zz District zz Family zz Workers Compensation COURT LOCATION: zz Providence/Sixth z Kent/Third z Newport/Second z Washington/Fourth FOREIGN LANGUAGE FLUENCY: If you are fluent in a foreign language, check the appropriate box below. z Spanish zz Portuguese zz Asian/Pacific zz Other ___________________ PANELS : Check the case panel for which you are seeking certification. Supreme Superior Family District WorkersComp zz Criminal zz Misdemeanor zz Wayward zz Misdemeanor zz Pro Se Appeals Appeals zz Delinquency zz Fines/Costs zz Guardian zz Class 2 Felonies zz Dependency Restitution zz Class 1 Felonies Neglect/Abuse zz Murder Cases zz Termination zz Guardian/ Parental Rights Personal Injury zz Waiver/ zz Guardian/Probate Certification/ zz Commissioner for Jury Trials Real Estate zz Guardian APPLICATION APPROVED: zz Receiver/Trustee zz Commissioner for zz Title Attorney Real Estate __________________________ zz Guardian/Tax/Title zz Child/Spousal zz Soldiers/Sailors Act Support Signature of Chief Judge zz Fines/Costs/ z Adult Criminal Restitution __________________________ Date G:\FormsCertification.lwp<<<<<<<<<********>>>>>>>>>>>>> 2 GENERAL REQUIREMENTS : Certify that you continue to meet each of the following requirements for appointment by writing your initials in the blank and providing any other information required. 1. I am a member of the Rhode Island Bar in good standing. ______ (initial) Years as a member:_____ 2. I have legal malpractice insurance in a minimum amount of $100,000 per claim/$300,000 aggregate with a Rhode Island licensed carrier. ______ (initial) A copy of the policy declaration sheet from your current professional liability policy must be attached. Name of Carrier: ____________________________________________________________________ 3. When appointed in cases which involve the handling and managing of funds , I will acquire bonding by a surety bond in an amount equal to the total funds being managed: ______ (initial) 4. I will serve as a mentor for attorneys seeking to qualify for court appo intment: ______ (initial) Attorneys may be removed from a panel if they refuse to accept an appoin tment without good cause shown. CONTINUING LEGAL EDUCATION: List the CLE courses and credit hours that you have taken in the last year that are required for the panel to which you are seeking appointment. Total hours required: ___________. 1. ___________________________________________________________ Credit h ours: _________ 2. ___________________________________________________________ Credit h ours: _________ 3. ___________________________________________________________ Credit h ours: _________ 4. ___________________________________________________________ Credit h ours: _________ 5. ___________________________________________________________ Credit h ours: _________ Total Hours Completed:_________________ EXPERIENCE : Circle the appropriate categories and then provide the information requi red. 1. The following are cases/trials/jury trials that I have handled as lead c ounsel/associate counsel to completion/verdict. These meet the requirements for appointment to the panel I have indicated. Case Case/Defendant Court Case Disposition Mentor NameNumber Name Type/Charge 1. _______ ___________________________ ___________________________ ______________2. _______ ___________________________ ___________________________ ______________3. _______ ___________________________ ___________________________ ______________4. _______ ___________________________ ___________________________ ______________5. _______ ___________________________ ___________________________ ______________ OTHER RELEVANT EXPERIENCE : Please describe other experience you have had that qualifies you for appointment to the panel you have indicated. Attorneys applying for app ointment in categories where required prior experience is not quantified must describe their practice sufficie ntly to demonstrate their competence. AFFIDAVIT: ___________________________________ being first duly sworn deposes and says that the information in this application is true. Signature of Applicant _________________________________________ Sworn to before me and subscribed in my presence this ______ day of ____ __________________ 20___ G:\FormsCertification.lwp
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