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BEFORE THE SUPREME COURT OF THE STATE OF

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Revised: 12/16/21
BEFORE THE SUPREME COURT
OF THE
STATE OF ARIZONA
IN THE MATTER OF
________________________. )
)
A MEMBER OF THE ) RESIGNATION OF MEMBERSHIP
STATE BAR OF ARIZONA )
STATE OF __________________)
) SS.
COUNTY OF ________________)
I, _____________________________________________________________________________________,
am a member of the State Bar of Arizona, holding Arizona Bar membership Number of_________________.
I reside at: ______________________________________________________________________________,
(complete address is required, including zip code)
My email address is:______________________________________________________________________
Pursuant to Rule 32(c) 12, Ariz.R.Sup.Ct., I herewith tender my resignation as a member of the State Bar of
Arizona and consent to the removal of my name from the roster of those admitted to practice before this Court
and from the membership roster of the State Bar of Arizona.
I avow that there are no disciplinary proceedings pending against me. I acknowledge that if this resignation
is accepted, it shall not be a bar to the institution of subsequent disciplinary proceedings for any conduct on
my part occurring prior to my resignation.
I understand that upon the Court’s approval of this resignation, my status will be “resigned in good standing”.
However, in the event that subsequent disciplinary proceedings result in my disbarment, suspension or
reprimand, I understand that my status will be changed from “resigned in good standing” to that of a person
so disciplined.
Further, pursuant to Rule 72(a), Ariz. R. Sup. Ct., within ten (10) days of the Court’s order of my resignation,
I shall comply with the requirements relating to notification of clients and others.
DATED this _____day of _______________, 20______ _______________________________________
Member’s Signature
SUBSCRIBED AND SWORN to before me
this ________day of _______________________, 20_______.
__________________________________________________
NOTARY PUBLIC
My Commission expires: _____________________________.
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BEFORE THE SUPREME COURT OF THE STATE OF

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Completed 18 March 2022

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