Renewal Certificate Of Compliance For Pro Hac Vice Admission - Oregon State Bar
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1RENEWAL
)
Certificate of Compliance
In re: _____________________________ )
For Pro Hac Vice Admission
Name of Out-of-State Attorney
)
I, ______________________________________________________(print name), am an attorney in the State of _______________
and I intend to seek renewal of my pro hac vice admission in accordance with ORS 9.241 and UTCR 3.170 in the following Oregon
court action or proceeding:
Case Name: ____________________________________________________________________
Court: _____________________________________________ Case No.: __________________
I
c ertify
t hat
a ll
i nformation
I
p rovided
t o
t he
O regon
S tate
B ar
i n
m y
i nitial
C ertificate
o f
C ompliance
f or
Pro
H ac
V ice
A dmission,
s igned
b y
m e
o n
_ __________________________,
2 0____,
r emains
t rue
a nd
c orrect,
a nd
that
I
c ontinue
t o
b e
b ound
b y
a ll
t erms
a nd
c onditions
o f
p ro
h ac
v ice
a dmission
a s
s pecified
i n
O RS
9.241
a nd
U TCR
3 .170.
I
s ubmit
$ 500
t o
t he
O regon
S tate
B ar
a s
p ayment
o f
t he
p ro
h ac
v ice
f ee
e stablished
b y
O RS
9 .241
a nd
t he
rules
o f
t he
O regon
S upreme
C ourt.
I
a cknowledge
t hat
t his
f ee
i s
f or
a
p eriod
o f
t welve
m onths
f rom
t he
date
o f
t he
A cknowledgment
o f
R eceipt
i ssued
b elow,
a nd
t hat
a n
a dditional
f ee
o f
$ 500
w ill
b e
r equired
in
o rder
f or
m e
t o
c ontinue
m y
p ro
h ac
v ice
a dmission
i n
t he
m atter
f or
e very
t welve-‐month
p eriod
thereafter.
Dated this __________________ day of____________________, 20 ____.
X____________________________
___________________ Bar No.: _____________
(Applicant Signature)
(Home Jurisdiction)
Mailing Address:______________________________
Phone: __________________________________
______________________________
FAX: __________________________________
______________________________
Email: __________________________________
_________________________________________
Acknowledgment of Receipt
As Director of Regulatory Services of the Oregon State Bar, I acknowledge receipt from the above-named out-of-state attorney of the
Renewal Certificate of Compliance for Pro Hac Vice Admission and attachments, and the $500 fee for pro hac vice appearance in the above-
referenced Oregon action or proceeding. The fee is for a period of twelve months from the date of this certificate.
Dated this ________________ day of____________________, 20 ____.
_______________________________________________________
Dawn Evans, Director of Regulatory Services
Oregon State Bar Regulatory Services, PO Box 231935, Tigard, OR 97281-1935
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