Attorney Registration Form {DC-BK ARF}

U.S. DISTRICT COURT / U.S. BANKRUPTCY COURTDISTRICT OF UTAHATTORNEY REGISTRATION FORM Bar ID: Name: Telephone: Office: Address: City, State Zip: Email Address(es): 1. erify informationabove; it is the Court's official record of howto reach you. Call(801) 524-6 if you have questions. 2.Pay one of two ways: By Mail:Complete this form with your original signature and mail it with creditcard information or a check made payable to "District Court Bar Fund"by July 1, 201, to: OR Online:If you have a CMECF login, you may pay online:a. Login at http://ecf.utd.uscourts.gov (with your e-filing login) b.From the blue bar in CM/ECF, click Civil, Attorney Annual Duesc.You will be prompted to pay your fees online through pay.gov.d.Continue the prompts ALL the way through, until you see thefinal Notice of Electronic Filing (NEF) screen. You will receive an emailconfirmation the following day.e.If you pay online, please retain this form for your records.(Note: Attorneys employed with a Federal agency may not pay online.) PAYM ENT MUST BE RECEIVED OR POSTMARKED BY JULY Please check desired Federal Bar membership status: Active....................................$.00(by 7/1/1) ($.00 after 7/1/) * No fee required if admitted after July 1, 201. Active ...................................No Fee*Inactive ...............................No Fee Pursuant to DUCivR 83-1.2, I hereby register as a member of the Bar of the U.S. District Court and the U.S. Bankruptcy Courtfor the District of Utah for July 1, 201 - June 30, 20. If selecting Active, I certify that: 1.I am a member in good standing of the Bar of this Court and an active member of the Utah State Bar,2. I have read and am familiar with the Rules of Practice of this court. 3.I acknowledge that the court has mandated electronic filing for all active members of its bar andwill comply accordingly.SignatureDate CREDIT CARD INFORMATION Type of Card:Name on Card:VisaAmerican ExpressAuthorizing Signature:MasterCardDiners ClubCredit Card Nbr/Exp Date: /DiscoverAmount Authorized: $ American LegalNet, Inc. www.FormsWorkFlow.com