Criminal Justice Act Voluntary Panel Questionnaire And Application | Pdf Fpdf Doc Docx | Texas

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Criminal Justice Act Voluntary Panel Questionnaire And Application | Pdf Fpdf Doc Docx | Texas

Criminal Justice Act Voluntary Panel Questionnaire And Application

This is a Texas form that can be used for Northern District within Federal, District Court.

Alternate TextLast updated: 6/16/2006

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UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF TEXAS DALLAS DIVISION CRIMINAL JUSTICE ACT VOLUNTARY PANEL QUESTIONNAIRE AND APPLICATION Please return original and three copies to: Attn.: CJA Panel Attorney Program Clerk, United States District Court 1100 Commerce Street, Rm. 14A20 Dallas, Texas 75242 A. General Information 1. Name: _____________________________________________________________________ (Last) (First) (Middle) 2. Office Address: ______________________________________________________________ (Firm Name) ______________________________________________________________ (Street) (City) (State) (ZIP) 3. Telephone Numbers: _______________________ _______________________ (Office) (Home) ______________________ ______________________ (FAX) (Pager) ______________________ (Mobile) 4. What is the best way to contact you in an emergency? ________________________________ ______________________________________________________________________________ 5. Bar Number: ____________________________________________ 6. Date Admitted to Texas Bar:________________________________ 7. Date Admitted to NDTX: ___________________________________ 8. What other Federal Districts have you been admitted to: ______________________________ ______________________________________________________________________________ 2000 (C) American LegalNet, Inc.<<<<<<<<<********>>>>>>>>>>>>> 2 9. Law School from which you received your JD:______________________________________ 10. Professional Affiliations: DBA JLT MABA AABA Other: __________________ Dallas Criminal Defense Lawyers Texas Criminal Defense Lawyers NACDL B. Trial & Legal Experience 11. Indicate your Criminal Trial experience by providing approximate totals in the following categories: Federal Court State Court Jury Trials _______________________ _______________________ Bench Trials _______________________ _______________________ Pleas & Sentences _______________________ _______________________ Appeals _______________________ _______________________ Other Court Hearings_______________________ _______________________ 12. Indicate your Civil Trial experience by providing approximate totals in the following categories: Federal Court State Court Jury Trials _______________________ _______________________ Bench Trials _______________________ _______________________ Other Court Hearings_______________________ _______________________ Depositions _______________________ _______________________ 13. Indicate any other legal experience which qualifies you for membership on the panel (including experience in a prosecutor=s or public defender=s office or as a judicial law clerk and areas in which you are a Board Certified Specialist): ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ CONTINUED ON NEXT PAGE. 2000 (C) American LegalNet, Inc.<<<<<<<<<********>>>>>>>>>>>>> 3 14. List the names and phone numbers of three judges and three lawyers who know of your ability as a trial attorney: Judges: Attorneys: ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ C. Miscellaneous Information 15. Have you ever been disciplined by, or are you the subject of a pending disciplinary complaint before any Bar Association or Court? Yes No If AYes@ please describe the facts concerning the discipline or the pending disciplinary complaint: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 16. Are you fluent in any foreign language(s)? Yes No If AYes@ please list: _________________________________________________________________ Are you willing to take additional appointments based on your foreign language proficiency? Yes No If AYes@ how many per year? _______________________ 17. How many court appointments would you like to receive annually?________________________ I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT. ______________________________________ _______________________________ Signature Date 2000 (C) American LegalNet, Inc.

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