Registration Renewal Of Attorney Specialty

Page 1 of 2 R EGISTRATION/ RENEWAL O F ATTORNEY SPECIALTY FORM: RPC 7.4(d)(3)(i) State Bar of Nevada 3100 W. Charleston Blvd., S uite 100 Las Vegas, NV 89102 Phone: (702) 382 - 2200 Toll Free (800) 254 - 2797 DATE SUBMITTED: S UBMITTED B Y: (Attorney name) (Bar number) (Firm name) (Address) (Phone number) (E - mail) 1 . Specialty registered : Proof of ce rtification attached. Certification issued by : (Name of approved organization that certifie d you) . This certification was first issued and is valid through . (Date) (Date) 2. Are you registering more than one specialty? You must attach a completed copy of this form, with the exception of #3 (fee) for each additional specialty (up to three total). There is only (1) fee if you register multiple specialties at this time or at annual renewal. 3 . Process my $250 re newal fee by Please mail original application with payment to: State Bar of Nevada 3100 W. Charleston Blvd., S ui te 100 Las Vegas, NV 89102 E x CV Applied American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 4. Attestation. By signing and submitting this form, the unde rsign ed attests to compliance with each of the following ( i nitial each item ) : I have verified that the organization which certifies my specialty as designated in item #2 herein is currently ABA Certified, or, approved by t he State Bar of Nevada Board of Governors. I have devoted at least one - third of my practice to the specialty designated in item #1 herein for the past two (2) years. I have completed ten (10) hours of continuing legal educa tion in the area of each designated specialty in the past year as listed b elow. *** C ompliance reports will not be accepted *** . List course name (s) and number of credits for each below: Professional liability insurance verification - Complete one of the following as it applies to you: I c urrent ly carry at least $500,000 in professional liability insurance and will maintain this insurance t hroughout my specialist registration . Proof of my coverage is attached . Required. RPC 7.4(d)(2)(iii) I am exempt from liabi lity c overage under RPC 7.4 because I practice exclusively public law. I am concurrentl y filing a copy of this form and its attachments with the Nevada Board of Continuing Legal Education, 457 Court Street, Reno, NV 89501 . (Required. RPC 7.4( d)(2)( iv) . SIGNATURE OF ATTORNEY REGISTERING SPECIALTY: I have personally read this form and att est to the accuracy of the information contained therein. Dated this day of , . (Print Name) (Sign Name) American LegalNet, Inc. www.FormsWorkFlow.com