Criminal Justice Act Panel Application Page 4

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VII.
Do you understand that the Criminal Justice Act will not provide indemnification for any
claims arising as a result of your representation of a CJA client?
Yes
No
VIII.
Do you have malpractice insurance?
Yes
No
If “No”, are you willing to accept appointment under these circumstances?
Yes
No
IX.
With respect to your legal practice, has a final adjudication or other finding ever been made
by an Bar Association, Ethics Committee, Court, or other judicial or quasi-judicial body
concerning your ethics or any other disciplinary matter?
Yes
No
If your response was in the affirmative, please explain fully and completely each such
finding.
X.
Are you enrolled for electronic filing and equipped to participate?
Yes
No
XI.
Provide the name, address, and telephone number of at least three references with substantial
knowledge regarding your credentials for panel membership:
4

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