APPLICATION TO SERVE AS TEMPORARY JUDGE
Application to Serve as Temporary
Judge
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN BERNARDINO
Please return completed Application to: Court Executive Office
Attn: Temporary Judge Administrator
247 West Third Street, Eleventh Floor
San Bernardino, CA 92415-0302
1. Contact Information
a.
Name:
b.
California
State
Bar
number:
c.
Business
address:
City:
State:
Zip:
Mailing
address
(if
different):
d.
E-mail:
e. Telephones:
State:
Zip:
Daytime:
Evening:
Fax:
Cell
(optional):
2.
Areas of Interest
a. I am willing to serve as a court-appointed temporary judge in the following types of cases (describe):
b. I am available to serve at the following times:
Morning Afternoon Evening
Days: Monday Tuesday Wednesday Thursday Friday
Saturday
Assignments on short notice
Other
(describe):
c. I am willing to serve at the following court locations:
All court locations.
The
following
locations
only:
d. I am not available to serve as follows (describe and explain):
3.
Professional and Personal Qualifications
a.
Date
of
admission
to
the
State
Bar
of
California:
b. I am also admitted to practice law in the states listed below:
Years
of
active
membership:
State: Date admitted:
State:
Date
admitted:
Bar No: Years of active membership:
Bar
No:
Years
of
active
membership:
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5
Administrative Office of the Courts Cal. Rules of Court, rule 6.744
[New July 1, 2006] www.courtinfo.ca.gov
State Bar Number:
Your
name:
4. Professional and Personal Qualifications (continued)
c. Are you in good standing in each state where you are licensed to practice law? Yes No
(If no, provide an explanation in Attachment 3c.)
d. I am certified as a specialist by the State Bar of California Board of Legal Specialization or by an organization
whose certification program has been accredited by the State Bar of California.
Areas of specialization:
e. I am certified as a legal specialist by other states or organizations as follows (specify):
Areas of specialization:
f. Have you ever been disciplined by the State Bar of California or by a bar association or other professional licensing
entity in any state or by a court of record, including being sanctioned or held in contempt?
Yes No
g. Do you have any disciplinary action pending against you by the State Bar of California or by a bar association or
other professional licensing agency in any state or by a court of record, including any proceeding for the imposition
of sanctions or for contempt? Yes No
h. Have you ever been convicted or pleaded no contest to a felony or misdemeanor?
Yes
No
i. Are you a defendant in any pending felony or misdemeanor proceeding? Yes No
j. Have you ever been a party to any legal proceeding? Yes No
(If you answered yes to questions 3f, g, h, i, or j, provide additional information in an Attachment.)
5. Practical Experience
a. The principal portion of my law practice in California is in the following courts (specify state and federal courts,
including trial and appellate courts, if applicable):
b. I currently practice in the following areas of law (list each subject area of law that occupies at least 10 percent of
your time):
c. Do you hold yourself out publicly as representing exclusively one side in any area of litigation practice?
Yes No (If yes, provide the following information):
Area of Practice Side Represented
d. Do you represent one side in more than 90 percent of your cases in any area of litigation practice?
Yes No (If yes, provide the following information):
Area of Practice Side Represented
[New July 1, 2006]
APPLICATION TO SERVE AS TEMPORARY JUDGE
Page 2 of 5
State Bar Number:
Your
name:
6. Experience as a Temporary Judge
a. Have you ever previously served as a temporary judge? Yes No
(If yes, describe in Attachment 5a your prior service, including the names of the courts and the locations where
you served, the approximate number and types of matters heard, and the approximate dates of service.)
b. Have you ever been removed by a court as temporary judge? Yes No
(If yes, describe the circumstances in Attachment 5b, including the court, the date you were removed, and the
reasons for your removal.)
7. Training
Describe any training that you have received that qualifies you (under California Rules of Court, rules 243.13243.14) to
serve as a court-appointed temporary judge, including the subjects, the dates, and the name of the court or other provider
of the training:
a. Bench conduct (describe):
b. Ethics (describe):
c. Small claims (describe):
d. Traffic (describe):
e.
Other
(describe):
Continued on Attachment 6.
8. Additional Information
Please respond to the following, if applicable:
a. The following facts concerning my background, situation, or circumstances may positively or negatively reflect
on me or on my suitability for appointment and should be disclosed to the court.
Continued in Attachment 7a.
b. I ask the court to consider the following additional facts in support of my appointment:
Continued in Attachment 7b.
[New July 1, 2006] Page 3 of 5
APPLICATION TO SERVE AS TEMPORARY JUDGE
State Bar Number:
Your
name:
9. Contact Persons
It may be necessary to contact you regarding matters on which you have been involved as a temporary judge. Please
list two individuals who will always know your whereabouts.
a. Name:
Business address:
First Last
Street City State Zip
Business
Telephone
no.:
(
)
b. Name:
E-mail
address:
Business address:
First Last
Street City State Zip
Business
Telephone
no.:
(
)
E-mail
address:
10. References
List two or more judicial officers who are familiar with your work:
11. I understand and acknowledge that the selection and appointment of a temporary judge is solely at the discretion of
the court for the purpose of assisting the public and does not constitute an employment relationship.
12. I am aware of and will comply with all provisions of the Code of Judicial Ethics and the California Rules of Court
concerning temporary judges.
I declare under penalty of perjury under the laws of the State of California that the foregoing, including statements made
in all attachments, is true and correct. I understand that any misstatement or omission of material fact may disqualify me
from serving as a temporary judge in this court.
Date:

(TYPE OF PRINT NAME OF APPLICANT) (SIGNATURE OF APPLICANT)
(This application is not complete unless the Waiver and Authorization for Release of Information on the next page is
signed by the applicant.)
[New July 1, 2006]
APPLICATION TO SERVE AS TEMPORARY JUDGE
Page 4 of 5
Application to Serve as Temporary
Judge
WAIVER AND AUTHORIZATION FOR RELEASE OF
INFORMATION
I have applied to be appointed as a temporary judge in the Superior Court of California, County of San Bernardino.
I hereby authorize the State Bar of California and the attorney-licensing authority in any other state where I am admitted
to practice law to release to an authorized representative of the court information regarding the following matters:
(1) whether I am in good standing or am otherwise authorized to practice law as a member of the State Bar of California or
as an attorney in any other state where I am admitted to practice law; (2) whether I have a record of discipline with
the State
Bar of California or with the licensing authority for attorneys in any other state where I am admitted to practice law; and (3)
whether any disciplinary investigation or proceeding is pending against me by the State Bar of California or by the
licensing authority for attorneys in any other state where I am admitted to practice law.
Date:

(TYPE OF PRINT NAME OF APPLICANT) (SIGNATURE OF APPLICANT)
(CALIFORNIA BAR NUMBER OF APPLICANT)
[New July 1, 2006]
APPLICATION TO SERVE AS TEMPORARY JUDGE
Page 5 of 5
Cal. Rules of Court, rule 6.744
www.courtinfo.ca.gov