Get free non-fillable PDF
This is a California form that can be used for Out Of State Attorney Arbitration Counsel within Statewide, State Bar.
Last updated: 6/15/2016Add to favorites $ 5.99
Download Now$ 5.99
Back to search
State Bar of California OSAAC Certificate Application for Out-of-State Attorney to Appear in an Arbitration Matter Questions: (415) 538-2111 è FOR OFFICIAL USE ONLY $50 No Pmt. File No.________________________ email@example.com 1) Case Information Case Name: Case Number: Name of arbitral forum or court: 2) Non-California Attorney Information Attorney Name: Office Address: City: Residence Address: City: E-mail: Fax: ( State: ) Zip: Phone: ( ) Yes Yes State: Zip: + + No No In the two years preceding the date of this form have you filed: (1) an application to appear as counsel pro hac vice in the State of California; (2) an OSAAC certificate pursuant to Cal. Code of Civ. Proc. §1282.4? If you answered 'yes' to question 1 or 2 complete Section I of Attachment B- Admissions/Standing List. Include ALL OSAAC and pro hac vice appearances in California. Complete Section II of Attachment B- Admissions/Standing List. Include all courts and jurisdictions in which you are admitted to practice. 3) California Counsel Information Attorney Name: Office Address: City: State: Zip: + Member # / Status: (e.g. 'Active') Attach additional sheets if more than one attorney is serving as California Counsel of Record 4) Attachments Attachment A: Declaration of Out-of-State Attorney appearing in an arbitration matter. The declaration must have an original signature. Attachment B: Admissions/Standing List. Copy of initial filing to appear in this matter. $50 Payment. Make check payable to the State Bar of California or attach credit card payment form. OS1010603 American LegalNet, Inc. www.FormsWorkFlow.com MAIL PAYMENT TO: The State Bar of California Office of Certification-OSAAC 180 Howard Street San Francisco, CA 94105-1639 State Bar of California OSAAC Certificate Application for Out-of-State Attorney to Appear in an Arbitration Matter ATTACHMENT A ATTORNEY DECLARATION (a) (b) I am not a member of the State Bar of California. I am currently a member in good standing of and eligible to practice law before each of the courts listed in Attachment B, section II. I am not currently on suspension or disbarred from the practice of law in any court. I have attached a copy of my disciplinary history, if any, to my application. I am not a resident of the state of California. I am not regularly employed in the State of California. I am not regularly engaged in substantial business, professional or other activities in the State of California. I agree to be subject to the jurisdiction of the courts of the State of California with respect to the law of the state of California governing the conduct of attorneys, to the same extent as a member of the State Bar of California. I am aware that filing a certificate containing false information or otherwise failing to comply with the standards of professional conduct required of members of the State Bar of California will subject me to the disciplinary jurisdiction of the State Bar of California with respect to any of my acts occurring during the course of the arbitration. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on: Print Name: (c) (d) (e) (f) (g) (h) (i) (j) Date: Signature: OS101A0603 American LegalNet, Inc. www.FormsWorkFlow.com State Bar of California OSAAC Certificate Application for Out-of-State Attorney to Appear in an Arbitration Matter ATTACHMENT B- Admissions/Standing List Section I Previous California Appearances Case Number Case Name Court or Forum Was Petition Granted? Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No Section II Admissions List Date Admitted State/Court (e.g. Ohio or USDC or 9th Circuit) Status (e.g. 'Active') Prior Record of Discipline If 'Yes' Please Attach Details Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No Attach additional sheets if necessary Check here if additonal sheets are attached listing details of prior record of discipline. OS101B0603 American LegalNet, Inc. www.FormsWorkFlow.com