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`IN THE UNITED STATES DISTRICT COURT
`FOR THE NORTHERN DISTRICT OF WEST VIRGINIA
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`Plaintiff(s),
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`v.
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`Defendant(s).
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`(CIVIL)(CRIMINAL) NO:
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`APPLICATION FOR ADMISSION PRO HAC VICE
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`I verify that I have fully complied with Local Rule of General Practice and Procedure 83.02
`as it relates to admission to practice pro hac vice.
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`Applicant’s Name
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`Representing (Party Name)
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` Name of Applicant’s Firm
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`Applicant’s Office Address
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` Applicant’s Office Telephone Number
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`Applicant’s Office Fax Number
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`_____________________________________________
`Applicant’s Email Address
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`Bar number where admitted, with name, address, and telephone of State Bars where admitted:
`Bar # and State:
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`List all matters before West Virginia tribunals or judicial bodies in which the applicant is or has been
`involved in the preceding twenty-four (24) months:
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`
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` PROVIDE ATTACHMENT WITH ADDITIONAL INFORMATION IF NECESSARY
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`
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`Case 1:23-cv-00089-TSK Document 9 Filed 12/04/23 Page 2 of 2 PageID #: 3443
`All matters before West Virginia tribunals or judicial bodies in which any member of applicant’s
`firm, partnership or corporation is or has been involved in the preceding twenty-four (24) months:
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`
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` PROVIDE ATTACHMENT WITH ADDITIONAL INFORMATION IF NECESSARY
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`I understand that admission to practice pro hac vice will result in my registration in the Case
`Management/Electronic Case Filing system. By this registration, I agree to abide by the
`requirements set forth in the Federal Rules, Federal Statutes and the Local Rules, Administrative
`Orders, procedures and policies of the United States District Court for the Northern District of West
`Virginia. (See https://racerweb.wvnd.uscourts.gov for further information).
`I understand that attorneys admitted pro hac vice will have privileges to view official docket
`sheets and documents associated with cases and query case reports for cases on the CM/ECF system
`using the Court-assigned read only login and password, and that I must submit all filings
`electronically through local counsel. Registration constitutes my consent to service by electronic
`means pursuant to the Federal Rules.
`I certify that I have:
`1) Submitted with this application the requisite fee of Two-Hundred Dollars ($200.00) payable
`to the Clerk of the Court of the United States District Court for the Northern District of West
`Virginia, and
`2) Paid to the West Virginia State Bar the West Virginia State Bar pro hac vice fee pursuant
`to Rule 8.0 of the Rules of Admission for the West Virginia State Bar.
`I certify that the foregoing application is true and correct. I hereby represent that I am a
`member in good standing with the bar of every jurisdiction in which I am admitted and my privileges
`to practice law and my membership in any bar association have never been amended, modified,
`suspended, revoked or otherwise limited in any way in any court, district, state, commonwealth or
`other jurisdiction. I also certify that I have never been convicted of a felony. I agree to comply with
`all laws, rules, and regulations of the United States Courts where applicable.
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`If unable to make the above representation, please attach an explanation.
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` Name of Responsible Local Attorney
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`Signature of Applicant
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`Office Local Attorney Telephone Number Name of Responsible Attorney’s Firm
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`___________________________________
` Responsible Attorney’s Email Address
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` Responsible Attorney’s Office Address
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`Pursuant to Local Rule of General Practice and Procedure 83.02, I have read the foregoing
`application and, by my endorsement hereon, agree to be a responsible local attorney in the above-
`styled matter. I certify that I am an active member in good standing of the West Virginia Bar and
`that I maintain an actual office in West Virginia from which I practice law on a daily basis. I hereby
`verify that the attorney moving for pro hac vice admission is a member of the bar or bars listed on
`page 1 of this application.
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`Signature of Responsible Local Attorney
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