COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Petition for Removal of CLER DelinquencyADMINISTRATIVE FEE$150.00Calendar No.TOTAL PAID$Send to: The Florida Bar Legal Specialization & Education 651 E. Jefferson St. Tallahassee, Florida 32399-2300 (850) 561-5842JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)PLEASE TYPE OR PRINT LEGIBLYATTORNEY # I,, hereby petition the Executive Director of The Florida Bar for removal of the CLER Delinquency on my membership record in The Florida Bar and certify:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1. I am not delinquent in payment of my annual membership fees.2. I did not comply with my previous CLER reporting periods beginning and ending .(If delinquent for more than one period, list all applicable periods.)THE PEOPLE OF THE STATE OF NEW YORK TO3. I am now in compliance with my continuing legal education requirement, Rule 6-10, by virtue of thefollowing: (Please check one) I have completed 30 general hours with 5 hours in ethics, professionalism, substance abuse or mental illness awareness. (Please attach all CLE course information.) I have completed more than 30 hours for all of the past reporting periods listed above. (Please attach all CLE course information covering all periods.) I wish to be reinstated based on the following applicable exemption covering the reporting period(s) listed above as indicated by Rule 6-10.3(c). GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County of4. I did not comply with CLER because:o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room5. During my delinquency, I have/have not (circle one) engaged in the delivery of legal services within theState of Florida or have given advice or rendered services on matters or issues involving or determined by Florida procedural or substantive law, either for a fee or pro bono.Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of the6. My current mailing address and telephone number are:Court in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)STATE Signature of PetitionerCOUNTY OF 10Petitioner (Name Typed, Printed or Stamped)pg.Attorney(s) forp65/cler2001.On this date , Before me, the undersigned authority, this day personally appeared , who is personally known to me or has produced as identification, who first being duly sworn says, that he or she is the petitioner in the above matter and the facts and matters set forth are true and correct.FormsforCLER/Office and P.O. AddressBLSE/Telephone No.: Facsimile No.: E-Mail Address: NotaryCLER-Send to: The Florida Bar Legal Specialization & Education 651 E. Jefferson St. Tallahassee, FL 32399-2300BarDepts/Mobile Tel. No.:h:/American LegalNet, Inc. www.USCourtForms.com
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