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Petitioner Name Address City State Zip Telephone Fax Form

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Petitioner Name Address City, State, Zip Telephone FaxSUPREME COURT OF THE STATE OF MONTANA No. IN RE PETITION OF (name) FOR REINSTATEMENT TO ACTIVE STATUS IN THE STATE BAR OF MONTANA _________________________ P E T I T I O N _________________________ COMES NOW (name) and respectfully petitions this Court for reinstatement to active status pursuant to Section 3 of the By- Laws of the State Bar of Montana. Petitioner was admitted to the State Bar of Montana on (date) Petitioner (check one):⁯Voluntarily chose inactive status on (date). ฀Voluntarily chose emeritus status on (date). ฀Voluntarily chose senior status on (date). ฀Was placed on inactive status by the State Bar of Montana pursuant to Rules 3B2, 5, and 12, of the Rules for Continuing Legal Education on (date) as a result of noncompliance ฀Was suspended for noncompliance with CLE requirements on (date). ฀Has been suspended for three or more consecutive years for nonpayment of dues. Petitioner was suspended on (date). Petitioner is willing and able to pay active dues, fees, and the state license tax to the State Bar of Montana and comply with any continuing education requirements this Court may impose. Petitioner is฀ is not฀ currently suspended, disbarred, or otherwise ineligible to practice law in another jurisdiction. (If so, provide the pertinent details.) Petitioner is฀ is not฀ currently subject to disciplinary proceedings or pending disciplinary proceedings in another jurisdiction. (If so, provide the pertinent details.) Petitioner has฀ has not฀ been charged with a criminal offense while not on active status. (If so, provide the pertinent details.) Petitioner has฀ has not฀ accrued delinquent debt or filed for bankruptcy while not on active status. (If so, provide the pertinent details.) Petitioner has฀ has not฀ failed to fulfill the obligations of a public office or professional license (other than as an attorney) while not on active status. (If so, provide the pertinent details.) Finally, petitioner has฀฀฀ has not฀ committed any acts or omissions while not on active status which would be sanctionable under the Montana Rules of Professional Conduct. (If so, provide the pertinent details.) WHEREFORE, petitioner requests reinstatement as an active member of the Stat e Bar of Montana. The above statements are true based upon petitioner’s knowledge and belief. DATED this day of , 20 . BY: Petitioner SUBSCRIBED AND SWORN TO before me this day of , 20 by (petitioner’s name). Notary Signature Printed Name of Notary (Notarial Seal) Residing at Notary Public for the State of My Commission Expires

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Fill and Sign the Petitioner Name Address City State Zip Telephone Fax Form