Affidavit In Support Of Application To Resign While Proceeding Or Investigation Is Pending - Supreme Court Of The State Of New York Page 15

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30.

Since the entry of the order of discipline, I have been arrested, charged with, indicted,

convicted, tried, and/or entered a plea of guilty to the following felonies, misdemeanors,

violations, and/or traffic infractions: [state the court, the offense charged, and date and nature of

disposition].

[Certificates of conviction pertaining to the above are attached as exhibit ___ hereto.]

- OR -

I attest that, since the entry of the order of discipline, I have not been arrested, charged with,

indicted, convicted, tried, and/or entered a plea of guilty to any felonies, misdemeanors,

violations, and/or traffic infractions.

31.

Since my admission to the Bar, I have been the subject of the following governmental

investigation(s): [state the name of the investigating agency and the nature and date of the

investigation].

- OR -

I attest that, since my admission to the Bar, I have not been the subject of any governmental

investigations.

32.

Since the entry of the order of discipline, I have suffered from or have been treated for

the following condition or impairment which in any way impairs or limits my ability to practice

law: [state the date or dates of each instance, including, but not limited to any mental, emotional,

psychiatric, nervous or behavioral disorder or condition, or any alcohol, drug or other substance

abuse condition or impairment or gambling addiction, and the date(s) of treatment, if any].

- OR -

I attest that, since the entry of the order of discipline, I have not suffered from or been treated for

any condition or impairment which in any way impairs or limits my ability to practice law.

33.

Within the 30 days preceding the execution of this affidavit, I have read the Rules of

Professional Conduct (22 NYCRR Part 1200.0). If reinstated to the practice of law, I will

conform my conduct to those rules.

34.

Since the entry of the order of discipline, I have complied with the requirements of

section 1240.16 (b) of the Uniform Rules for Attorney Disciplinary Matters by attaining a

passing score on the Multistate Professional Responsibility Examination (MPRE).

[Proof of passage of the MPRE is attached as exhibit ___ hereto.]

35.

Since the entry of the order of discipline, I have completed ____ credit hours of

continuing legal education in the following programs and other educational classes, in order to

remain current with developments in the law:

[Certificates attesting to my completion of the aforementioned programs or classes are attached

as exhibit ___ hereto.]

- OR -

Since the entry of the order of discipline, I have not completed any credit hours of continuing

legal education.

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