Pro Hac Application – State Bar of Nevada

Pro Hac Application - Out-of-State Counsel

Application for Pro Hac Vice / Association of Counsel in Nevada State Courts.

Case Information

Name of Court(Required)

Name of Administrative Body

Case No.(Required)

Dept. No.(Required)

Plaintiff(Required)

Defendant (Enter N/A if the case caption does not include a defendant).(Required)

Petitioner Information

Name - First, Middle, Last, Suffix(Required)

Petitioner is an attorney at law and a member of the law firm: (enter firm name)(Required)

Firm Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone No. xxx-xxx-xxxx(Required)

Petitioner's Email(Required)

Petitioner has been retained personally or as a member of the above named law firm to provide legal representation in connection with the above-named matter by:(Required)

Select all state(s) in which you are an attorney in good standing and regularly practice law. Hold ctrl key to select multiple states. The highlight lines may disappear but the data will be saved. Upload state certificates of good standing below.(Required)

Upload Certificate(s) of Good Standing, from each state, issued within the past 30 days; do not include certificates from federal courts. If your certificate was emailed to you from your bar or Supreme Court, include the email.(Required)

Max. file size: 100 MB.

List the court(s) and other state(s) to which you have been ADMITTED to practice AND the date of admission for each. Upload certificate(s) for each state below.

Is Petitioner currently suspended or disbarred in any court?(Required)

Yes

Provide Details Below

Is Petitioner currently subject to any disciplinary proceeding by any organization with authority at law?(Required)

Yes

Provide Details Below

Has Petitioner ever received discipline including, but not limited to, suspension or disbarment, by any organization with the authority to discipline attorneys at law? If yes, provide details below.(Required)

Yes

Provide particulares to include court, discipline authority, brief statement of event(s).

Has Petitioner ever had any certificate or privilege to appear and practice before any regulatory administrative body suspended or revoked?(Required)

Yes

Provide particulars e.g. date, administrative body, date of suspension or reinstatement.

Has Petitioner, either by resignation, withdrawal, or otherwise, ever terminated or attempted to terminate Petitioner's office as an attorney in order to avoid discipline, disbarment or suspension proceedings?(Required)

Yes

Provide Details Below

Has Petitioner filed an application under Nevada SCR 42 in the past three years?(Required)

No prior applications have been submitted in the past three years by petitioner.

One prior application has been filed.

Two prior applications have been filed.

Three prior applications have been filed.

Four prior applications have been filed.

Five prior applications have been filed.

Six or more. Attach exhibit for prior applications. Exhibit must Include Date of Application, Case No., Name of Court, and Status of Application i.e. Granted/Denied

If petitioner has filed more than five applications within the past three years, they must also submit an affidavit of special circumstances.

Application 1: Date of Application xx/xx/xxxx(Required)

Application 1: Case No.(Required)

Application 1: Name of Court (Select One)(Required)

Application 1: Was the Application Granted or Denied by the Court?(Required)

Granted

Denied

Pending

Case settled/closed or party withdrew prior to admission being granted.

Application 2: Date of Application xx/xx/xxxx(Required)

Application 2: Case No.(Required)

Application 2: Name of Court (Select One)(Required)

Application 2: Was the Application Granted or Denied by the Court?(Required)

Granted

Denied

Pending

Case settled/closed or party withdrew prior to admission being granted.

Application 3: Date of Application xx/xx/xxxx(Required)

Application 3: Case No.(Required)

Application 3: Name of Court (Select One)(Required)

Application 3: Was the Application Granted or Denied by the Court?(Required)

Granted

Denied

Pending

Case settled/closed or party withdrew prior to admission being granted.

Application 4: Date of Application xx/xx/xxxx(Required)

Application 4: Case No.(Required)

Application 4: Name of Court (Select One)(Required)

Application 4: Was the Application Granted or Denied by the Court?(Required)

Granted

Denied

Pending

Case settled/closed or party withdrew prior to admission being granted.

Application 5: Date of Application xx/xx/xxxx(Required)

Application 5: Case No.(Required)

Application 5: Name of Court (Select One)(Required)

Application 5: Was the Application Granted or Denied by the Court(Required)

Granted

Denied

Pending

Case settled/closed or party withdrew prior to admission being granted.

Upload exhibit if Petitioner has six or more prior applications within the past three years.

Max. file size: 100 MB.

Nevada Counsel Information

Name - First, Middle, Last, Suffix(Required)

Nevada Counsel Bar No.(Required)

Firm Information(Required)

Firm Name Address City State / Province / Region ZIP / Postal Code Country

Telephone No. xxx-xxx-xxxx(Required)

Nevada Counsel Email(Required)

Petitioner agrees to comply with the provisions of Nevada SCR 42(3) and (13) and Petitioner consents to the jurisdiction of the courts and disciplinary boards of the State of Nevada in accordance with provisions as set forth in SCR 42(3) and (13). Petitioner respectfully requests that Petitioner be admitted to practice in the above-entitled court for the purposes of this matter only.(Required)

I agree

Petitioner has disclosed in writing to the client that the applicant is not admitted to practice in this jurisdiction and that the client has consented to such representation.(Required)

I agree

Petitioner Affirmations(Required)

Upload any additional documents here that you would like us to have.

Max. file size: 100 MB.

File

Max. file size: 100 MB.

I understand that by typing my name and clicking "Submit", I am electronically signing this document.(Required)

I understand and agree.

Typed Signature(Required)

Date Submitted(Required)

Non-Refundable Application Fee (Select Standard or Expedited)(Required)

Total Due

Payment Method(Required)

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date

Month Year

Security Code Cardholder Name

Billing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Mail Check Made Payable to State Bar of Nevada to

State Bar of Nevada, 3100 W. Charleston Blvd., Suite 100, Las Vegas, NV 89102. Be sure to include a note as to who and what the payment is for so it will be routed correctly. Your application will be processed upon receipt of payment.

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