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IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF OHIO : Plaintiff, -vsDefendant, : : : Case No.: District Judge Magistrate Judge (Revised 4-20-10) MOTION FOR ADMISSION PRO HAC VICE Pursuant to S.D. Ohio Civ. R. 83.3(e) and 83.4(a), (Name of Trial Attorney) attorney for (Name of Party) admit , trial , in the above-referenced action, hereby moves the court to , pro hac vice to appear and participate as counsel or co-counsel (Name of PHV Attorney) . (Name of Party) Movant represents that (Name of PHV Attorney) is a member in good standing in this case for of the highest court of as attested by the accompanying certificate from that (Name of State) court and that (Name of PHV Attorney) permanent bar of this Court. This Motion is accompanied by the required $200.00 fee. is not eligible to become a member of the understands that, unless expressly excused, he or (Name of PHV Attorney) she must register for electronic filing with this Court promptly upon the granting of this Motion. American LegalNet, Inc. www.FormsWorkFlow.com `s relevant identifying information is as follows: (Name of PHV Attorney) Business telephone ____________________ Business fax _________________________ Business address ____________________________________________________________ ____________________________________________________________ Business e-mail address _______________________________________________________ _______________________________________ (Signature of Trial Attorney) _______________________________________ (Address) _______________________________________ (City, State, Zip Code) _______________________________________ (Telephone Number) Trial Attorney for (Name of Party) (Please attach required Certificate of Service) American LegalNet, Inc. www.FormsWorkFlow.com