Notice Of Foreign Attorney Status

COMMONWEALTH OF PENNSYLVANIA GOVERNOR'S OFFICE PENNSYLVANIA HUMAN RELATIONS COMMISSION In the matter of: Case No.: Appearing on Behalf of: NOTICE OF FOREIGN ATTORNEY STATUS I hereby certify that I am an attorney at law admitted to practice before the highest court of _____________________________, as evidenced by the attached copy of my current (name of jurisdiction) license to practice before such court (a card or similar credential evidencing the current ability to practice before such court shall suffice). I further certify that my client in this matter is aware of my status as an out of state attorney and agrees to my representation, as evidenced by the attached POWER OF ATTORNEY. ____________________________________ Signature ____________________________________ Name (Printed) ____________________________________ P.O. Address ____________________________________ City, State, and Zip Code ____________________________________ Telephone (including area code) ____________________________________ Date American LegalNet, Inc. www.FormsWorkFlow.com