Compliance Affidavit Form Oregon
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1Oregon State Bar, Regulatory Services, PO Box 231935, Tigard, OR 97281‐1935
COMPLIANCE AFFIDAVIT
In the Matter of the Application of:
)
)
)
BR 7.1 Reinstatement
For Reinstatement as an
)
Not Effective Until Approved by
Active/Inactive (circle one)
)
the Oregon State Bar
Member of the Oregon State Bar
)
1. Full Name
Bar #
Date of Birth
2. Email Address:
3. Residence Address
Phone
4. I hereby attest that during my period of suspension from the practice of law from
_____________ to _____________ (insert dates),
□
I did not at any time engage in the practice of law except where authorized to do so.
OR
□
I engaged in the practice of law under the circumstances described on the attached
[attach an explanation of activities relating to the practice of law during suspension].
5. I hereby attest that I have responded to the requests for information or records by
Disciplinary Counsel or the Local Professional Responsibility Committee and have complied
with any subpoenas issued by Disciplinary Counsel or the Local Professional Responsibility
Committee, or provided good cause for not complying to the request.
I,
, the undersigned, being first duly sworn, depose, and say
that the above answers are true and correct as I verily believe.
Applicant
State of _______________________
)
) ss.
County of ______________________
)
Subscribed and sworn to before me this ________ day of _______________, 20_____.
Notary Public for
My Commission Expires:
I, Helen Hierschbiel, Executive Director of the Oregon State Bar, do hereby certify that the above‐name
applicant for reinstatement has met all necessary requirements for reinstatement under BR 7.1 of the
Rules of Procedure and is hereby reinstated as an active/inactive (circle one) member of the Oregon
State Bar.
Dated this ______ day of __________, 20____.
Helen Hierschbiel, Executive Director
BR 7.1 Reinstatement
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