Reinstatement From Inactive Status Or Administrative Suspension Short Form - North Carolina Page 3
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42. During the time you were inactive or suspended, indicate whether you were: (You must answer YES
or NO to each question below)
(a) Engaged in the practice of N.C. law after the 30 day wind-down period or anytime while the
suspension or inactive status was in effect _____
(b) Disciplined by a professional licensing organization _____
(c) Have any disciplinary complaints, investigations or actions pending before a professional licensing
organization _____
(d) Disciplined (including criminal or civil contempt) by a tribunal _____
(e) Convicted of a violation of law (excluding infractions in which appearance may be waived by
paying a fine) _____
(f) Failed to file and/or pay your state or federal taxes on time ____
(g) Declared legally incompetent _____
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(h) Impaired
from a mental health disorder _____
(i) Impaired from the use of alcohol or drugs _____
IF YOU ANSWERED “YES” TO ANY OF THE ABOVE, ATTACH RELEVANT DOCUMENTS
(including any court order or order of discipline) AND AN EXPLANATORY STATEMENT
PROVIDING SPECIFIC INFORMATION.
3. State the reason you desire readmission to the North Carolina State Bar and provide an explanation of
your anticipated employment.
4. Is there any reason why your resumption of the practice of law may be detrimental to the integrity and
standing of the Bar, or subversive of the administration of justice or the public interest? _______
If your answer is YES, provide an explanation including a description of any relevant conduct.
By executing this petition, you acknowledge that you have answered each question truthfully and
completely.
___________________________________________________
_____________________________
Signature
Date
Sworn to and subscribed before me this
______ day of ____________, ________.
_________________________________
Notary Public
My commission expires: _____________
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“Impaired” or “impairment” means limited in your ability to carry on any life activities to an extent that would have
adversely affected your ability to practice law. The ability to practice law requires, among other attributes, an
accurate perception of reality, honesty, and the capacity to comprehend facts and circumstances, to reason logically, to
communicate, to recognize and appropriately resolve ethical dilemmas, and to perform legal tasks in a timely manner.
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