Fill and Sign the Attorney Certificates Central District of California Form

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA REQUEST FOR ATTORNEY ADMISSION INFORMATION To: Deputy Clerk Date: From: Name of Requestor Address Telephone Number City, State, Zip Code Re: I hereby request the following: GCertificate of Good Standing (for attorneys currently admitted to the bar of this Court). Name of Attorney CA State Bar No. No. of Certificates Fee* $18.00 $18.00 $18.00 G Duplicate Admission Certificate (May only be requested by the attorney or attorney’s firm). Name of Attorney CA State Bar No. No. of Certificates Fee* $18.00 $18.00 $18.00 Original certificate is: G Lost G Damaged G Destroyed G Name changed G Other (Original certificate must be returned, if available.) G Verification of Admission Name of Attorney CA State Bar No. Search Fee $30.00 $30.00 $30.00 A $30.00 search fee will be charged in addition to the $18.00 certificate fee if a search is necessary. If more than one certificate is requested on this form for the same attorney, and a search fee is necessary, one search fee will be charged plus $18.00 for each certificate. Make cashier’s check, certified bank check, business or corporate check, government-issued check, or money order drawn on a major American bank or the United States Postal Service payable to Clerk, U.S. District Court. The Clerk's Office will also accept credit cards (Mastercard/Visa, Discover, American Express) for filing fees and miscellaneous fees. Credit card payments may be made at all payment windows where receipts are issued. PERSONAL CHECKS ARE NOT ACCEPTED. Mail this completed form and fee to: Attn: Fiscal Section United States District Court Central District of California 312 N. Spring Street, Room 529 Los Angeles, CA 90012 Note: Requests for a Certificate of Good Standing and for Verification of Admission will be processed within three (3) business days of receipt. Requests for duplicate Admission Certificates are processed within four (4) weeks of receipt. Please allow an additional three (3) days for mailing. If you do not receive the certificate or verification within that time, you may call (213) 894-2085. G-63 (3/13) REQUEST FOR ATTORNEY ADMISSION INFORMATION* CLEAR FORM