Motion To Appear Pro Hac Vice With Certificate Of Service And Order

(Rev. 6/12/13) UNITED STATES DISTRICT COURT WESTERN DISTRICT OF LOUISIANA DIVISION Case No. Plaintiff VS. Judge Magistrate Judge Defendant MOTION TO APPEAR PRO HAC VICE In accordance with the local rules for the United States District Court, Western District of Louisiana, application is made to be admitted pro hac vice to the bar of this court for the purpose of appearing on behalf of in the above described action. · I am ineligible to become a member of this court, but I am a member in good standing of the bar of the United States District Court for the District of or the bar of court, which is the highest court of such state. Attached hereto is a certificate of good standing from such court. · Payment of the applicable fee of $105.00 is made via the court's electronic filing system using Pay.gov. · There have been no disciplinary proceedings or criminal charges instituted against me. · In accordance with the local rules for the United States District Court, Western District of Louisiana, is appointed a local counsel. of the firm of Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com (Rev. 6/12/13) · I authorize the Clerk of Court for the Western District of Louisiana to transmit notice of entries of judgments and orders to me under Fed.R.Civ.P. 77, Fed.R.Cr.P. 49, LR 5.7.10. I also agree to receive notice electronically from other parties and the court via electronic mail. I understand that electronic mail filter software (SPAM filter) may interfere with receipt of e-mail notices and have verified that any such software installed on my computer or network will not filter our messages sent from Clerk@lawd.uscourts.gov. I understand this electronic notice will be in lieu of notice by any other means. I understand it is my responsibility to advise the Clerk's Office promptly in writing of any physical address changes and/or update my electronic mail address within the court's electronic filing system. Respectfully submitted, Signature of Applying Attorney Applying attorney must sign. No "s/ signature" accepted. Signature of Local Counsel Local counsel may use typed "s/ signature" and must file electronically. PLEASE TYPE OR PRINT LEGIBLY: Name: Firm: Address: LOCAL COUNSEL INFORMATION: Name: Firm: Address: Telephone: Fax: E-mail: Additional e-mail(s): Telephone: Fax: E-mail: Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com (Rev. 6/12/13) Certificate of Service I hereby certify that on , I presented the foregoing Petition for Admission Pro Hac Vice to the Clerk of Court for filing and uploading to the CM/ECF system which will send notification of such filing to the following: , and I hereby certify that I have mailed by United States Postal Service this filing to the following non-CM/ECF participants: . Signature Name: Firm: Address: Telephone: Fax: E-mail: Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com (Rev. 6/12/13) UNITED STATES DISTRICT COURT WESTERN DISTRICT OF LOUISIANA DIVISION Case No. Plaintiff VS. Judge Magistrate Judge Defendant ORDER IT IS ORDERED that admitted to the bar of this Court pro hac vice on behalf of in the above described action. SO ORDERED on this, the day of , be and is hereby . U.S. Magistrate Judge American LegalNet, Inc. www.FormsWorkFlow.com