22 CRR-NY D V Form CNY-CRR
22 CRR-NY D V Form C
22 CRR-NY D V Form C
1 Proposed uniform application for license as a legal consultant
PROPOSED UNIFORM APPLICATION FOR LICENSE
AS A LEGAL CONSULTANT
Appellate Division, Supreme Court
Judicial Department
Committee on Character and Fitness
APPLICATION FOR LICENSE AS A LEGAL CONSULTANT
______
_____________________________
DIRECTIONS
(Read all these directions carefully before attempting to answer any question.)
(1) This is a statement made under oath. Applicant's failure fully and accurately to disclose any fact or information called for by any question may result in the denial of the application, or if applicant shall have been licensed before the discovery thereof, in the revocation of the applicant's license.
(2) Answers must be in BLACK INK, preferably in typewriting, but may be in applicant's handwriting or hand printing.
(3) Unless otherwise indicated, every question and every part of each question must be answered, even though the answer be negative.
(4) Where “Yes” or “No” suffices, employ that form in answer.
(5) If the applicant cannot comply with any of the requirements, he must state in detail the efforts he has made to comply and why he cannot. Answers on information and belief will be accepted only in connection with matters which the applicant cannot be expected to remember because of extreme youth or other equally sufficient reason. All statements made on information and belief must be so designated in the sworn statement, and the sources of information must be given.
(6) Should the space left for any answer be insufficient, the applicant shall complete his answer on a rider page, specifying the number of the question to which it relates. More than one rider may occupy a rider page. Each rider should be signed.
(7) In stating addresses give street and number, if any, city, village, county and state or foreign country.
(8) In giving a period which is countinuing at the date of verification of this sworn statement, always give such period as continuing “to date”.
_____________________________
TO THE APPELLATE DIVISION OF THE SUPREME COURT OF THE STATE OF NEW YORK, __ JUDICIAL DEPARTMENT
The undersigned hereby applies for a license as a legal consultant pursuant to the Judiciary Law (§ 53, subd. 6) and the Rules of the Court of Appeals (22 NYCRR Part 521) and in support of such application submits the following sworn statement and the accompanying affidavits and other papers:
1. (a) State name in full (First) (Middle) (Last)
(b) Have you ever used or been known by any other name?
__
If so, state in full each name (other than the name above given) which you have used or by which you have at any time been known, the period of, and the reasons for the use of each such name.
(If change of name was made by court order, submit a certified copy of order; if by marriage, so state.
)
(c) United States Social Security Number, if any __.
2. State the following:
(a) Age, date, and place of birth.
(b) Of what country are you a citizen?
(c) If you are a naturalized or derivative citizen of the United States, give the date when and place where naturalization or right to derivative status was acquired.
(d) If you are not a citizen of the United States, state (i) the category, date and place of issue of your United States visa, and (ii) whether, and if so, when, a certificate of alien registration or an alien registration receipt card has been issued to you.
(Such visa and, if issued, certificate or card must be exhibited at the time of submitting this application.
)
(e) Present residence (full mailing address).
(f) Full names of all persons with whom you are presently living, and relationship to you.
(g) Length of actual residence in the State of New York immediately preceding the submission of the application, stating when such actual residence commenced.
If you had any prior residence in this State, give dates and places thereof.
3. State whether married or single __. If ever married, answer the following:
(a) When, where, and to whom married; give spouse's name, together with any other name by which spouse has been known.
(If married more than once, list marriages chronologically.
)
(b) Do you reside with your spouse?
__
If not, state reasons for separation (if through divorce, annulment or separation, submit certified copy of decree, judgment or order FOR EACH SUCH ACTION).
4. Give the following information as to residence:
(a) The cities and states or countries in which you resided for more than one year from the date of your birth until your admission to practice as an attorney or counselor at law or the equivalent.
(If answer is on information and belief, state source of information.
)
(b) List below, every permanent residence you have ever had including the present, in the United States or elsewhere, since your admission to practice as an attorney or counselor at law or the equivalent in any foreign jurisdiction, with exact address of each, and the year of the beginning and ending of each such residence.
(Exclude military addresses unless off base.)
Permanent Residences
)
(Continue permanent residences if necessary.)
5. Did you graduate from high school or its equivalent?
__
If so, state name and place of school and date of graduation.
6. List colleges, universities and professional schools (other than law schools) attended, giving month and year of the beginning and ending of attendance at each, and degrees received. If you did not receive a degree, state the reason.
)
7. List law schools attended, giving month and year of the beginning and ending of attendance at each, and degrees received If you did not receive a degree, state the reason.
)
If you received your legal education other than by attendance in a law school, state the details with respect thereto.
(a) Have you ever been denied admission to any school, college, law school or other similar institution for cause which might reflect upon your character? __
(b) Have you ever been placed on probation, or dropped, or suspended or expelled from, or have you withdrawn from or left, any institution of learning above elementary school level, or otherwise been subjected to discipline for conduct by any such institution, or requested (or advised) for any reason to discontinue your studies in any law school? __
If your answer is “Yes” to either (a) or (b), give the name of any such institution and state the circumstances and date of each such occurrence.
10. State the following:
(a) The country or countries, and the particular state or other territorial division thereof, in which you have been admitted to practice as an attorney or counselor at law or the equivalent.
(b) The date of each such admission to practice, the name and address of each court, tribunal or other authority by which you were so admitted, and the character, nature and scope of the practice allowed thereby.
(c) The period or periods of time during which you practiced as such attorney or counselor at law or the equivalent in each such country, and all the office addresses where you so practiced, with the names and addresses of partners, if any.
11. Give a detailed statement of the character, nature and extent of your practice in such other country or countries, specifying whether your practice was in the area of litigation or in other areas and elaborating on the specific legal services rendered by you.
12. State:
(a) Legal professional associations or societies to which you have belonged,
(b) Legal publications which you have written.
13. State whether you have ever been reprimanded, disciplined, suspended or disbarred as an attorney or counselor at law or the equivalent, or whether any charges or complaints have ever been preferred against you.
If so, state the nature of the charges and their disposition.
14. If you have ever been employed in or associated with any law office, law department or legal institution, whether of a private or governmental nature, give the following information with respect thereto (enumerating the same in chronological order, and including employments by members of family or other relatives and employments with or without monetary compensation):
)
15. Are you now or have you ever been employed in a business, profession or occupation other than law? __ If so, enumerate all such employments in chronological order. Include employments by members of family or other relatives and employments with or without monetary compensation.
)
16. Are you now, or have you ever been engaged on your own account or as a partner with others in any occupation, business or profession other than law? __
If so, give in detail the nature and location thereof and the month and year of the beginning and ending of your engagement in or connection therewith.
If any such business was carried on by you in partnership with others, give the name and addresses of all partners and the nature of the business.
If the business was carried on by a corporation in which you held any office, state its name, address, nature of the business and your connection with it.
List (a) every action now pending against such firm or corporation, of which you have knowledge, and (b) every judgment entered against it during the period of your association with it.
17. Have you ever been discharged by any employer?
__
If so, give the name of each such employer stating date, cause and circumstances of discharge.
18. Do you affirmatively represent that, in connection with all your employments, your services were satisfactory and that you were not discharged nor were your services terminated for cause, nor were you requested or advised to resign from or leave any such position?
__
If answer is “No”, give full details as to each such incident.
19. (a) Have you ever heretofore applied for licensing as a legal consultant or for admission to the Bar of the State of New York in this or any other Department? __
(b) Have you ever engaged in or has your conduct ever been called into question with reference to the unauthorized practice of law? __
(c) Have you ever been employed by or otherwise connected with any person, firm, or corporation whose conduct was called into question on the subject of unauthorized practice of law while you were so employed or connected? __
(d) Have you ever tried any action or proceeding, argued any motion, drawn legal papers, given legal advice or held yourself out as an attorney or counselor-at-law in this State? __
If your answer is “Yes” as to any part of this question, state the matter fully.
20. (a) Have you ever registered as a law student, or applied to take or taken the bar examination, in any country, state or jurisdiction other than the State of New York and other than the country or countries in which you have been admitted to practice as stated by you in this application?
(b) Have you ever applied for admission to practice as an attorney or counselor at law or the equivalent in any country, state or jurisdiction other than the State of New York and other than the country or countries in which you have been admitted to practice as stated by you in this application?
__
If your answer to (a) or (b) is “Yes”, state specifically the disposition made of the application or the result of the bar examination.
21. Have you ever been rejected for service in any of the armed forces of the United States or of any other country?
__
If your answer is “Yes”, give date and reason, stating facts fully, whether the reason be physical, mental, moral or otherwise.
22. (a) Have you at any time or in any manner, served in any of the armed forces of the United States, including reserves?
__
If the answer is “Yes”, state (1) when, where, and which service; (2) period and nature of service rendered; (3) if discharged give date and nature of discharge and submit photocopy of each release or discharge certificate.
(b) Have you served in the armed forces (reserves or otherwise) of any country other than the United States of America?
__
If the answer is “Yes”, give name of country, inclusive dates of service, and reason for separation from service.
(Submit photocopy of each release and discharge).
23. As a member of any armed forces have you been the subject of any charge, or complaint, formal or informal, or has any proceeding been instituted against you, or have you been a defendant in any court martial proceeding?
__
If answer is “Yes”, state the facts.
24. State whether you have ever:
(a) testified or been called as a witness in any action, proceeding or investigation to which you were not a party?
__
(b) been ticketed, or summoned, or arrested, or taken into custody, or indicted, or convicted, or tried for, or charged with, or pleaded guilty to, the violation of any law, ordinance, traffic or parking regulation or the commission of any felony or misdemeanor, or been requestedto appear before any prosecuting or investigative agency in any matter?
__
(Indicate all such incidents, including proceedings as a juvenile or youthful offender, no matter how minor the infraction or whether guilty or not.
Although a conviction may have been expunged from the records by order of court or other competent authority, it nevertheless should be disclosed in the answer to this question.
(c) failed to answer on the return date any ticket, summons or other legal process served upon you at any time?
__
If so, was any warrant, subpoena, or further process issued against you as a result of your failure to respond to such legal process?
(d) been adjudged an incompetent, or had proceedings brought to have you adjudged an incompetent; or have you been committed to or been a patient in any institution for the care of persons suffering from mental or nervous disorders or drug addiction, drug abuse or alcoholism?__
(e) been charged with fraud or any other act involving moral
(f) been a party to or otherwise involved in any action, proceeding or investigation (civil or criminal) not covered by answers to the foregoing subdivisions hereof?
__
If your answer is “Yes” to any subdivision of this question indicate the subdivision and state the facts as fully as possible and give in each case name and locality of court or agency, dates of beginning and termination of action or proceeding, and the judgment or other disposition.
25. (a) Are there any unsatisfied judgments against you?
__
If so, list the same giving name and address of each judgment creditor and the court by which judgment was rendered, together with the date and amount thereof and the nature of the claim on which it was based.
(b) Are you in default in the performance or discharge of any duty or obligation imposed upon you by any governmental agency or decree or order of any court including alimony and support orders and decrees?
__
If so, state the facts.
(c) Are you indebted to anyone?
__
If so, list all debts stating name and address of creditor and amount, date, nature and status of indebtedness.
26. (a) Have you ever applied for a license the procurement of which required proof of good character?
__
If granted, state, as to each such license, the approximate date it was granted and the name of the authority granting it.
(b) If your application for any such license was not granted, state the facts.
(c) Have you ever held a bonded position?
__
If so, specify the nature of position, dates, amount of bond, and whether or not anyone ever sought to recover on your bond or cancel the same?
27. (a) Have you ever organized or helped to organize or become a member of any organization or group of persons — except for membership in the armed forces of any country during the time that such country has been at war with the United States — , which during the period of your membership or association, you knew was advocating or teaching that the government of the United States should be overthrown or overturned by force, violence or any unlawful means?
__
If your answer is in the affirmative, state the facts below.
(b) If your answer to (a) is in the affirmative, did you, during the period of such membership or association, have the specific intent to further the aims of such organization or group of persons to overthrow or overturn the government of the United States by force, violence or any unlawful means?
28. Is there any reason why you cannot take and subscribe to an oath or affirmation that you will support the constitution of the United States and of the State of New York?
__
If there is, please explain.
29. Have you ever been disciplined, expelled, suspended or ordered to resign from any club, association, society or organization?
__
If your answer is “Yes”, state the facts.
30. (a) Have you read the Code of Professional Responsibility adopted by the New York State Bar Association?__
(b) Do you commit yourself to observe the Code of Professional Responsibility of the New York State Bar Association to the extent that such Code is applicable to the legal services which you will be authorized to render, as provided in section 521.3 of Part 521 of the Rules of the Court of Appeals, if you are licensed to practice as a legal consultant? __
31. (a) Have you read Part 521 of the Rules of the Court of Appeals? __
(b) Do you commit yourself to observe the restrictions prescribed by section 521.3 of Part 521 of such Rules on the nature and scope of the legal services that you will be permitted to render if you are licensed to practice as a legal consultant?__
I understand that this application is a continuing application, and that I must give correctly the information herein sought as of the date of my appearance before the Appellate Division to be sworn in as a legal consultant. I will, therefore, before such appearance, notify the Secretary of the Committee as to any change in respect of any matter concerning which information is herein sought.
I will also submit such additional affidavits or papers, and supply such additional information as may be requested.
Attached hereto is my designation of the Clerk of the Appellate Division, __ Department, to accept service in my behalf. I will promptly notify the Clerk in writing of any change in my address.
Signature of applicant
STATE OF
___
)
) ss. COUNTY OF __ )
I, __, being duly sworn, say: I have read the foregoing questions and have fully, truthfully and accurately answered the same. The foregoing answers are true of my own knowledge, except if stated to be made upon information and belief, and as to such answers, I believe them to be true.
Signature of applicant (Sign as above)
Subscribed and sworn to before me this __ day of __, 19
APPELLATE DIVISION
OF THE
SUPREME COURT
DEPARTMENT____
COMMITTEE ON CHARACTER
AND FITNESS
APPLICATION
and
SWORN STATEMENT
of
APPLICATION FOR LICENSE AS LEGAL CONSULTANT
Received ______
DESIGNATION OF AGENT FOR SERVICE OF PROCESS
(Type or print)
I, __, the undersigned applicant for license to practice as a legal consultant, do hereby irrevocably designate the Clerk of the Appellate Division of the Supreme Court, Judicial Department, as my agent upon whom process may be served with like effect as if served upon me personally in any action or proceeding hereafter brought against me and arising out of or based upon any legal services rendered or offered to be rendered by me within or to residents of this State, whenever after due diligence service in such action or proceeding cannot be made upon me within the State of New York at the address listed below or at such new address as I shall hereafter file in the office of such Clerk by means of a duly acknowledge supplemental instrument in writing.
My present address is
Dated:__, 19
STATE OF
___
)
) ss. COUNTY OF __ )
On this __ day of __, 19 , before me personally appeared __, to me known and known to me to be the person described in and who executed the foregoing designation and he duly acknowledged to me that he executed the same.
Notary Public, State of New York
CHANGE OF ADDRESS
(Type or print)
I, __, the undersigned, licensed to practice as a legal consultant by the Appellate Division of the Supreme Court, __ Judicial Department on the __ day of __, 19 , do hereby amend the “Designation of Agent for Service of Process” filed by me with the Clerk of said Appellate Division at the time of my admission to practice as follows:
My present residence is
Dated: __, 19
(Type or print name signed above)
STATE OF
___
)
) ss. COUNTY OF __ )
On this __ day of__, 19 , before me personally appeared __ to me known and known to me to be the person described in and who executed the foregoing change of address and he duly acknowledge to me that he executed the same.
Notary Public, State of New York
22 CRR-NY D V Form C
Current through May 31, 2021
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