APPELLATE DIVISION
OF THE
SUPREME COURT
SECOND DEPARTMENT
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COMMITTEE ON CHARACTER
AND FITNESS
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APPLICATION
and
SWORN STATEMENT
OF
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APPLICATION FOR ADMISSION TO THE BAR
RECEIVED ________
Form 1
Issued ________ Office Telephone ________
Submitted ________ Home Telephone ________
COMMITTEES ON CHARACTER AND FITNESS
SECOND JUDICIAL DEPARTMENT
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APPLICATION FOR ADMISSION TO THE BAR AND STATEMENT REQUIRED
PURSUANT TO ARTICLE 94 OF THE CIVIL PRACTICE LAW AND RULES
DIRECTIONS
(Read all these directions carefully before attempting to answer any question.)
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To the Appellate Division of the Supreme Court of the State of New York, Second Judicial Department:
The undersigned hereby applies for admission to practise as an attorney and counselor-at-law in all courts of the State of New York, and in support of such application submits the following sworn statement and the accompanying affidavits and other papers:
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(First) (Middle) (Last)
(If change was made by court submit copy of petition, a certified copy of the order and certificate of compliance therewith.)
Age, date, and place of birth.
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If a naturalized or derivative citizen, state date when and place where naturalization or right to derivative status was acquired, and submit certificate of naturalization or equivalent from any governmental office. (Such certificate will be returned.)
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Present residence (give full mailing address).
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Full name of all persons with whom you are presently living, and relationship to you.
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Length of actual residence in the State of New York.
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If ever married, answer the following:
When, where, and to whom married; give spouse's full name, together with any other name by which spouse has been known. (If married more than once, list marriages chronologically.)
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Do you reside with your spouse? ________
If not, state reasons for separation. (If through divorce, annulment or separation, submit copy of pleadings, certified copy of decree, judgment or order and proof of compliance with any directive portions thereof.)
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The cities and states or countries in which you resided for more than three months from the date of your birth until you first entered high school or its equivalent. (If answer is on information and belief, state source of information.)
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The full and exact address of your residence at the time you first entered high school or its equivalent.
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State every permanent residence you have ever had, in the United States or elsewhere, since first entering high school or its equivalent with exact address of each, and the month and year of the beginning and ending of each such residence. (Exclude military addresses unless off base.)
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Have you ever been placed on probation, or dropped, or suspended or expelled from, or have you withdrawn from or left any institution of learning, or otherwise been subjected to discipline, by any such institution, or requested or advised for any reason to discontinue your studies therein temporarily or otherwise? ________
If your answer is yes to either (a) or (b), give the name of any such institution and state the cause, circumstances and date of each such occurrence.____________
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If answer is no, give full details as to each such incident.
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If so, where, when, and with what result?
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Have you ever engaged in or has your conduct ever been called in question with reference to the unauthorized practice of law?
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Have you ever been employed by or otherwise connected with any person, firm, or corporation whose conduct was called in question on the subject of unauthorized practice of law while you were so employed or connected?
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Have you ever tried any action or proceeding, argued any motion, drawn legal papers, given legal advice or held yourself out as an attorney or counselor-at-law in this State? If you have done any of these, state the facts.
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If your answer is yes as to any part of this question, state the matter fully ________
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Have you applied for admission to practice as an attorney or counselor in any country, state or jurisdiction other than the State of New York? ________ If your answer to (a) or (b) is "Yes", state specifically the disposition made of the application or the result of the bar examination; if admitted, (a) give the name and address of each court by which admitted, the date of such admission, the periods of practice and all the office addresses where you have practiced, with the names and addresses of partners, if any and (b) whether you have ever been reprimanded, disciplined, suspended or disbarred as an attorney or counsellor-at-law or whether any charges or complaints have ever been preferred against you, and if so, the nature of the charges and their disposition.
(Applicants admitted in other jurisdictions must submit proof from each Grievance Committee, or body entertaining complaints against lawyers, certifying as to whether charges have been filed with such Committee or body against the applicant, and, if so, the substance of the charges and the disposition thereof. Instruction Sheet D may be obtained from Committee Office.)
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If so, state:
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Original classification and each reclassification, giving date of each such classification.
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Have you served in the armed forces (reserves or otherwise) of any country other than the United States of America? ________ If the answer is yes, give name of country, inclusive dates of service, and reason for separation from service. (Submit photostat of each discharge or release.)
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(Answer each subdivision of this question "Yes" or "No.")
testified or been called as a witness in any action, proceeding or investigation to which you were not a party; ________
been ticketed, or summoned, or arrested, or taken into custody, or indicted, or convicted, or tried for, or charged with, or pleaded guilty to the violation of any law, ordinance, traffic or parking regulation or the commission of any felony, or misdemeanor, or been requested to appear before any prosecuting or investigative agency in any matter? ________
(Indicate all such incidents, including proceedings as a juvenile offender, no matter how minor the infraction or whether guilty or not. Although a conviction may have been expunged from the records by order of court, it nevertheless must be disclosed in the answer to this question.)
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failed to answer on the return date any ticket, summons or other legal process served upon you at any time? ________ If so, was any warrant, subpoena, or further process issued against you as a result of your failure to respond to such legal process?
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been declared a ward of any court, or adjudged an incompetent, or have any proceedings been brought to have you declared a ward of any court or adjudged an incompetent, or have you been committed to any institution or been a paient in any institution for the care of persons suffering from mental or nervous disorders or drug addiction, drug abuse or alcohoism?
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been charged with fraud or any other matter involving moral turpitude?
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been a party to or otherwise involved in any action or proceeding, or investigation either civil or criminal, not covered by answers to the foregoing subdivisions of this question?
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If your answer is "Yes" to any subdivision of this question, state the facts in detail and give in each case name and locality of court or agency, dates of beginning and termination of action or proceeding, and the judgment or other disposition below.
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Are you in default in the performance or discharge of any duty or obligation imposed upon you by any governmental agency or decree or order of any court including alimony and support orders and decrees? ________
If so, state the facts.
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Are you indebted to anyone? ________If so, list all debts stating name and address of creditor and amount, date, nature and status of indebtedness.
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Has any one ever asserted a claim or demand against you, which has not been made the subject of any action or legal proceeding? ________ If so, state the facts and the present status of the matter.
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Have you ever asserted any claim or demand against any person, partnership or corporation, or governmental agency which has not been made the subject of any action or legal proceeding? ________
If so, state the facts and the present status of the matter.
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If your application for such a license was not granted state the facts.
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Have you ever held a bonded position? ________ If so, specify the nature of position, dates, amount of bond, and whether or not anyone ever sought to recover on your bond or cancelled the same?
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If your answer is in the affirmative, state the facts below.
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Can you conscientiously and do you affirm that you are, without any mental reservation, loyal to and ready to support the Constitution of the United States?
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Will you conscientiously endeavor to conform your profession conduct to them? ________
(THE FOLLOWING TWO PARAGRAPHS ARE TO BE COPIED BY THE APPLICANT IN HIS USUAL HANDWRITING IN THE SPACE PROVIDED BEFORE THE SIGNATURE OF THE APPLICANT.)
I understand that this application is a continuing application, and that I must give correctly the information herein sought as of the date of my appearance before the Appellate Division to be sworn in as an attorney and counselor-at-law. I will, therefore, before such appearance, notify the Secretary of the Committee as to any change in respect of any matter concerning which information is herein sought.
I will also submit such additional affidavits or papers, and supply such additional information as may be requested.
COPY FOREGOING TWO PARAGRAPHS HERE
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Signature of applicant
(Must conform to name on Certificate of State Board of
Law Examiners)
STATE OF ________)
) ss.
COUNTY OF ________)
I, ________, being duly sworn, say: I have read the foregoing questions and have fully, truthfully and accurately answered the same. The foregoing answers are true of my own knowledge, except if stated to be made upon information and belief, and as to such answers, I believe them to be true.
Signature of applicant
(Sign as above)
Subscribed and sworn to before me this
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of ________, 19________
CERTIFICATE OF COMMENCEMENT OF CLERKSHIP
[cf. § 520.4 ]
(Type or print)
I, the undersigned, an attorney admitted to practice law in the State of New York, do hereby certify that
(Type or print name of regular law clerk and student)
who is at least eighteen years of age, having been born at ________ on the ________ day of ________ 19 ________ has this day commenced the study of law in my office located at ________ New York, as a regular law clerk and student under section 520.4 of the rules of the Court of Appeals for the admission of attorneys and counselors-at-law (22 NYCRR 520.4).
Dated ________,19________.
Attorney at Law
Name____________
Address____________
Date of Admission____________
SCHEDULE A
(To be completed by law clerk/student)
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STANDARD FORMS FOR APPLICATIONS FOR ADMISSION
TO PRACTICE AS AN ATTORNEY AND COUNSELLOR AT LAW
STATE OF NEW YORK
APPELLATE DIVISIONS OF THE SUPREME COURT
COMMITTEES ON CHARACTER AND FITNESS
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INSTRUCTIONS TO APPLICANTS FOR ADMISSION TO THE BAR
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GENERAL INSTRUCTIONS
(Applicable in All Judicial Departments)
Strict compliance with these instructions is required. Incomplete, defective or carelessly prepared papers will occasion delay and may result in the rejection of the application.
Any false statement contained in the applicant's papers, or any failure to disclose any material fact, may result in the denial of the application for admission; or if the applicant shall have been admitted before the discovery thereof, in the revocation of his license to practice law.
Applicants should read carefully section 90 of the Judiciary Law, Article 94 of the Civil Practice Law and Rules, and the Rules of the Court of Appeals regarding the admission of attorneys and counsellors-at-law.
Do not submit affidavits of character from (a) other applicants, (b) persons related to the applicant or (c) members of the faculty or administrative staff of any law school which the applicant has attended.
Filing Offices
First Judicial Department Appellate Division, First Department
27 Madison Avenue - Room 101
New York, New York 10010
Second Judicial Department Secretary, Committees on Character and Fitness
Appellate Division, Second Department
185 Montague Street
Brooklyn, New York 11201
Third Judicial Department Clerk
Appellate Division, Third Department
Justice Building
Albany, New York 12223
Fourth Judicial Department Clerk
Appellate Division, Fourth Department
501 Hall of Justice
Rochester, New York 14614
SPECIAL INSTRUCTIONS
Summary Statement -- The applicant should submit with his other papers a Summary Statement on the form provided for that purpose.
Manner of Submission of Papers -- All papers must be submitted personally at the Appellate Division Court House, 25th Street and Madison Avenue, Room 101, New York, N.Y., except that the papers may be submitted by mail if the applicant is under military or other demanding circumstances which preclude personal submission.
Manner of Submission of Papers -- All papers must be submitted to the appropriate filing office of the Appellate Division, noted above, personally or by mail.
SUPREME COURT OF THE STATE OF NEW YORK
Appellate Division: [________] Judicial Department
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In the Matter of the Application of
Affidavit of Good
Moral Character
For Admission as an
Attorney and Counselor at Law
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STATE OF ________)
) ss.
COUNTY OF ________)
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(Signature)
Sworn to before me this ________
day of ________, 19________
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Notary Public [FN3]
(DO NOT FORGET TO HAVE AFFIDAVIT NOTARIZED)
NEW YORK SUPREME COURT, APPELLATE DIVISION,
DEPARTMENT
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IN THE MATTER OF THE APPLICATION
of
Affidavit of
Legal Employment
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(Insert name of applicant)
for Admission to Practice as an Attorney
Counselor-at-Law
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STATE OF ________)
) ss.
COUNTY OF ________)
(he) (she) executed the same.
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If so, give the following facts:
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Name and address of employer (individual, firm or corporation).
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If applicant was not in your individual employ, state your position with employer during the employment. (For example, member of employing firm, head of law department of a corporation, managing attorney, or other position.)
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Period, or each period, of employment, giving month and year of beginning and ending of each period, or if employment still continues, state that it continues to date.
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Each position held by applicant and nature of his duties.
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Nature and frequency of your personal contacts with applicant during the employment.
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Whether or not you had personal supervision of his work, or any part thereof, during the entire employment or any part thereof.
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If you did not have personal supervision, give name and position of each person having supervision.
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State whether or not applicant's duties were satisfactorily performed. If not, state in what respects such performance was defective.
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(Insert date)
Sworn to before me this
________day of 19 ________
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(Affiant to sign here)
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(Attesting officer to sign here)
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(Official designation)
(If affidavit is sworn to outside the State of New York, attach clerk's certificate)
[FN1] State either college or university degree or degrees, the college or university and the date; or, if not a graduate of an accredited college, the number of your law student's qualifying certificate.
[FN1] Give name of applicant as it appears on the certificate of the State Board of Law Examiners.
[FN2] Affiant must state that applicant is a person of good moral character and set forth the facts in detail under paragraph 8.
[FN3] If affidavit is sworn to outside the State of New York, attach clerk's certificate.
N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. V, Application for admission to the bar