Fillable Form 1.: I APPLICATION FOR APPOINTMENT TO THE (Administrative Office of the Illinois Courts)

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Form 1.: I APPLICATION FOR APPOINTMENT TO THE (Administrative Office of the Illinois Courts)

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I
APPLICATION FOR APPOINTMENT
TO THE OFFICE OF ASSOCIATE JUDGE
PURSUANT TO RULE 39 OF THE SUPREME COURT OF ILLINOIS, I HEREBY SUBMIT MY
NAME AS A CANDIDATE FOR APPOINTMENT TO THE OFFICE OF ASSOCIATE JUDGE OF
JUDICIAL CIRCUIT.
(Enter “Cook” or Circuit Number)
Please print or type application. Use additional pages when necessary to provide complete answers to questions.
PART A: PERSONAL BACKGROUND
1.
(A)
Name
(Last) (First)
(Middle)
(B)
Maiden or other name(s) by
which you may have been known:
2.
ARDC Number
3.
(A)
Date of Birth (B) Place of Birth
4.
Home Address
(Street) (City) (County) (Zip)
(Telephone)
5.
Business Address
(Street) (City)
6.
List previous addresses within the past ten years (include dates):
Home
7.
(A)
If you hold a current Illinois Driver’s License or Secretary
of State Identification card, please enter number:
(County) (Zip)
(Telephone)
Business
(B)
Enter name of any other state(s) in which you have ever
been licensed to drive a vehicle:
(C)
Has your driver’s license ever been suspended or revoked? □ Yes □ No
(If yes, please attach an explanation)
8.
Do you have any family relationships, including family members within the third degree of
relationship, which could cause a conflict of interest with your position as an associate judge?
□ Yes □ No
If yes, please explain below: (Canon 3 of the code of Judicial Conduct, Supreme Court Rules.)
Revised September 17, 2019
THE CIRCUIT COURT OF THE
TWELFTH
Associate Judge Application
Page 2
Revised September 17, 2019
9.
Are your currently in default on the repayment of a state educational loan? □ Yes □No
(Public Act 85-827 requires a person who owes $600 or more for six months or more to make satisfactory repayment arrangements with the
guarantor of the loan.)
10.
Are you currently in default on the payment of child support? □ Yes □ No
11.
Military Service (Duty with federalized National Guard unit should be reported as “active duty.”)
Branch Dates
Highest Rank
Attained
Type of Discharge
Active Duty Service
Reserve Service
National Guard Service
PART B: HEALTH
Notice to applicants: If you require an accommodation because of a physical or mental disability in order to participate in any
phase of the application process, please make that fact known to the Chief Judge of the Circuit which is accepting applications. All
information received regarding such requests and accommodations made will be treated confidentially.
1.
Are you presently consuming alcohol or other drugs, including prescription drugs, to the extent that such consumption would
interfere with your ability to serve on the bench? (If yes, explain below, or attach additional pages, if necessary.)
□ Yes □ No
2.
Have you violated any criminal laws of the United States or any state pertaining to the possession, use or sale of illegal drugs?
(If yes, explain below, or attach additional pages, if necessary.)
□ Yes □ No
3. Have you violated any criminal laws of the United States or any state pertaining to driving under the influence of alcohol,
drugs, intoxicating compound, or any combination thereof or other similar offense? (If yes, explain below, or attach
additional pages, if necessary.)
□ Yes □ No
4. The essential functions of an associate judge include, among other things, the ability to sit or remain in one place for extended
lengths of time, to conduct court proceedings in an orderly fashion, to remain alert while concentrating on the presentation of
evidence and arguments, to evaluate the credibility of witnesses, to comprehend and rule upon factual and legal questions and to
discharge the administrative duties attendant to the position. Are you able to perform the essential mental and physical
functions of an associate judge with or without reasonable accommodation?
(If no, explain below, or attach additional pages, if necessary.)
□ Yes □ No
Associate Judge Application
Page 3
Revised September 17, 2019
PART C: EDUCATIONAL BACKGROUND
1. (A)
Name of School Location Dates Major Degrees
High School
College (s)
Law School (s)
(B)
List Honors, Awards, Law Review, and other activities or achievements.
2.
Continuing Education attended in the last five years. (Such as seminars, symposia, lectures, or legal meetings, specifying if you
participated as a speaker, lecturer, panelist, etc.)
Type Your Participation Topic
3.
Complete the following if you have ever taught any law courses.
School (s)
Date(s)
Subject(s)
Position Held
Current Status
Associate Judge Application
Page 4
Revised September 17, 2019
4.
If you have written any articles, texts, treatises, handbooks or other writings on legal matters which
have been published, please complete the following:
Complete Citation
Date
Title
Subject Matter
Co-authors
5.
Describe any non-legal teaching or lecturing you have performed:
School(s)
Subject(s)
Position Held
Current Status
6.
Bar Associations and Activities
List all national, state, local, specialty, honorary and other bar associations or other legal societies
to which you now belong or have belonged.
Association
Office Held/Dates
Current or Past Member
Associate Judge Application
Page 5
Revised September 17, 2019
PART D: PROFESSIONAL, BUSINESS AND OCCUPATIONAL BACKGROUND
1.
Professional Qualifications
(A)
Date you were admitted to practice law in Illinois
(B)
Length of time you have practiced law in Illinois
(C)
Length of time you have practiced law in the circuit in which you are
seeking judicial appointment.
(D)
If you have been admitted to practice and/or actively practiced law in another state, please
complete the following:
Actively
State(s) Court(s)/Administrative Agency Currently Licensed
Practicing
2.
Practice/Employment
List, in reverse chronological order, the history of your practice or employment since your graduation from law
school, whether law related or not.
Your Status
Type of
Dates
Name of Firm, Address
Solo, Partner, Associate
Practice/ Nature
To From Company or Institution (City/State) or Title Within
of Work
Organization
Associate Judge Application
Page 6
Revised September 17, 2019
3.
If you have been engaged in the practice of law, indicate the approximate percentage of time devoted to the following types
of practice
. (“Litigation” includes, in addition to actual time in court or tribunal, preparation therefore. “Court” indicates federal and state judicial
system; “Trib” indicates quasi-judicial tribunals, e.g. Industrial Commission, NLRB hearings, etc.; “Non-Lit” indicates practice not involving litigation.)
Type of Practice
Litigation Court %
Litigation Other Trib. %
Non-Lit %
Anti-Trust & Trade Regulation
Bankruptcy
Chancery
Corporate and Securities
Criminal (Felony)
Criminal (Misd./Traffic)
Environmental
Family Law
Labor Relations
Patent
Probate & Estate Planning
Real Estate
State & Local Government
Tax (Federal)
Tax (State, Local)
Tort (Personal Injury)
Tort (P.D., Subrogation)
Worker’s Compensation
Other:
Other:
4.
(A)
Jury Trial Experience (Please state your jury trial experience in actual or approximate numbers.)
Jury Cases to Verdict
Jury Cases Started But Which Did
Not Go to Verdict
Civil Criminal Civil Criminal
As Lead Trial Counsel
As Counsel Assisting at Trial
(B)
List the last two jury cases tried to verdict, during the past five years, including names of other attorneys and Judge.
Case One Case Two
Name of Case
Case Number
County
Judge
Attorney(s)
Associate Judge Application
Page 7
Revised September 17, 2019
5.
Non-Jury Trial Experience (Please state in actual or approximate numbers.)
(A)
(B)
Civil Criminal
Number of contested Non-Jury cases commenced
How many of these cases went to judgment after the trial on the merits?
6.
Appellate Practice
(A)
How many cases have you personally handled as counsel on appeal?
(B)
How many cases have you orally argued?
(C)
List the five most significant cases you have personally handled as counsel on appeal, including citation.
(If case argued by yourself, place check indicated.)
√ If Argued
Yourself
IF APPELLATE COURT DISPOSITION WAS BY RULE 23 ORDER, PLEASE ATTACH COPIES OF ORDERS, IF YOU HAVE THEM.
7.
List any elective public office you have held.
Office Location Period of Service
Associate Judge Application
Page 8
Revised September 17, 2019
8.
List any appointive public office you have held:
Office Location Dates To/From Duties
√ Either Column
Part-
Time
Full-
Time
9.
Non-Law Related - Professional and Occupational Background
(A)
List all professional or occupational licenses (other than law) which you have held.
License Issuing Authority Date(s)
(Please √ if
license is still
current
)
(B)
If any such license has ever been revoked or suspended, or if your conduct has been the subject of other
discipline or complaint to the licensing authority or its disciplinary body, state fully the facts, circumstances
and the disposition.
Associate Judge Application
Page 9
Revised September 17, 2019
10.
List, in reverse chronological order, any business interest you, or your spouse, now have, or have had in the past, excluding
securities in a publicly traded corporation and any interest previously disclosed in this application.
Name of Business Type of Business
Your or Spouse’s
Relationship to Business (i.e.
Directorship)
Date(s)
To/From
11.
Have you individually, your spouse, or any business with which you have been affiliated, declared bankruptcy?
(If yes, state details below.) □ Yes □ No
I
Associate Judge Application
Page 10
Revised September 17, 2019
PART E: PROFESSIONAL AND PERSONAL CONDUCT
1.
(A)
Has your license or right to practice before any state or federal court, agency, or other tribunal ever been denied,
revoked or suspended?
□ Yes □ No
If yes, state the facts and circumstances fully. (Attach additional pages, if necessary.)
(B)
Have you ever been formally censured, adjudged or held in contempt or otherwise disciplined by any judge, court,
agency or other tribunal?
□ Yes □ No
If yes, state the facts and circumstances fully. (Attach additional pages, if necessary.)
(C)
Has your professional conduct or ability been the subject of comment, favorable or unfavorable, in a written opinion of
any judge, court, or other tribunal?
□ Yes □ No
If yes, state the facts and circumstances fully. (Attach additional pages, if necessary.)
Associate Judge Application
Page 11
Revised September 17, 2019
2.
To your knowledge, has your professional conduct or ability been the subject of any criticism or complaint filed with or
made to the Attorney’s Registration and Disciplinary Commission of Illinois or to any similar authority of any other court
or state?
□
Yes
□ No If yes, state the facts and circumstances fully, including the disposition.
(Attach additional pages, if necessary.)
3.
To your knowledge, are you now the subject of any investigation by any governmental or professional authority?
□ Yes □ No If yes, state the facts and circumstances fully.
(Attach additional pages, if necessary.)
4.
Have you ever pleaded guilty to or been convicted of a felony or misdemeanor?
If yes, please complete the following:
(Attach additional pages, if necessary.)
Court
Case Number
Your Attorney’s Name,
Address, Phone
Type of Offense
Additional Information
Concerning Facts and
Circumstances of Offense
Disposition, Including
Supervision
Associate Judge Application
Page 12
Revised September 17, 2019
5.
Have you ever been a party to, or otherwise personally involved in, any litigation (other than as counsel?)
□ Yes □ No
If “yes”, please complete the following:
Court
Case
Number
Case Name
Your Attorney or
Counsel
Name/Address/
Phone
Atty.
Representing
Interest Adverse
to Yours
Nature of Case Disposition
6.
Have you, individually, or in connection with any business with which you were associated, failed to file, in an accurate and
timely manner, any federal or state income tax return (or supporting documents) which has resulted, or may result, in the
imposition of criminal penalties?
(If yes, give details)
□ Yes □ No
7.
Have you, within the preceding five years, filed a Statement of Economic Interests pursuant to the Illinois Governmental
Ethics Act or Supreme Court Rule?
(If yes, attach a copy of the most recent Statement filed with each agency.)
□Yes □
No
I
Associate Judge Application
Page 13
Revised September 17, 2019
PART F: PERSONAL AND JUDICIAL REFERENCES
1.
Provide the following information on at least four lawyers not associated with you in the practice of law or in business who
ha
ve knowledge regarding your character and ability
.
Name Address
Phone & Email
Address
Relationship (e.g. Friend)
Length of time
known to you
1.
2.
3.
4.
5. (Optional)
2.
Provide the following information on at least one personal reference who has adequate opportunities for observing your
pr
ofessional and general conduct and ability
.
Name Address
Phone & Email
Address
Relationship (e.g. Friend)
Length of time
known to you
1.
2. (Optional)
3. (Optional)
4. (Optional)
5. (Optional)
I
Associate Judge Application
Page 14
Revised September 17, 2019
3.
Provide the following information for at least three, but not more than five, judges before whom you have appeared recently
in
matters which would afford them an opportunity to observe your professional conduct and ability
.
P
ART F: ADVERSARY REFERENCES
1.
Complete the following information for lawyers who have represented adverse positions in matters handled by you in the
p
ast five years. There are two categories, litigation and non-litigation. Do not list the name of a lawyer in one category
if
t
hat name is listed in the other. If you have had multiple matters with a listed lawyer, indicate that fact by checking t
he
c
olumn provided and state the name of the most recent, or most significant, case or transaction handled with that lawyer
.
(A) Litigation Matters
Name of Judge
City
Phone & Email Address
Name of Case
1.
2.
3.
4. (Optional)
5. (Optional)
Name of Lawyer Address/City
Phone & Email
Address
Name of Case
Approx.
Date
√
If
Multiple
Cases
1.
2.
3.
4.
5. (Optional)
I
Associate Judge Application
Page 15
Revised September 17, 2019
(B) Non-Litigation Matters
PART G: ADDITIONAL INFORMATION
1.
List any special professional, occupational or other experiences you have had, not otherwise listed in this application, which
yo
u believe would assist in the evaluation of your application
.
2.
As an applicant or candidate for any judicial or other office, have you been screened by any court, bar association, law
en
forcement agency or any other group or organization?
□ Yes □ No
(If yes, please state the office, organization, date and bar poll rating, if any, below or attach additional pages, if necessary.)
3.
You may list any civic, philanthropic, community, social or public service organizations in which you have been involved
du
ring the past ten years, including any posts or offices held, and honors or awards received
.
4.
State below, or on a separate attachment, any additional information or observation which you believe would assist the court
in its evaluation of your application for appointment by the court.
Name of Lawyer Address/City Phone &
Email Address
Name of Case or
Description of
Transaction
Approx.
Date
√
If
Multiple
Cases
1.
2.
3.
4.
5. (Optional)
Associate Judge Application
Page 16
Revised September 17, 2019
AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION
CERTIFICATION AND WAIVER
I hereby certify that I am registered as an attorney under Supreme Court Rule 756, and my fees are paid. I have
also reviewed the requirements of Illinois Supreme Court Rule 68, and I am prepared to comply with its
disclosure requirements.
I authorize the Administrator of the Attorney Registration and Disciplinary Commission to disclose to the Circuit
Circuit, or to any screening committee designated by the Circuit Court of the
Circuit, all information contained in the files of the Attorney Registration and
Disciplinary Commission concerning my present status, any complaints which have been made against me, and
the disposition of those complaints. I expressly waive whatever right I may have to the confidentiality of
that information required by Supreme Court Rule 766 and by any other statute, rule or regulation providing for
the confidentiality of that information by the Attorney Registration and Disciplinary Commission.
I do hereby authorize a review of, and full disclosure of, all records concerning myself to any duly authorized
agent of the Illinois State Police, whether the said records are of a public, private, or confidential nature. I
understand that any information obtained by a personal history background investigation which is developed
directly or indirectly, in whole or in part, upon this release and authorization will be considered in determining
my suitability for appointment as associate judge. I also certify that any person(s) who may furnish such
information concerning me shall not be held accountable for giving this information; and I do hereby release said
person(s) from any and all liability which may be incurred as a result of furnishing such information. I further
release the Illinois State Police from any and all liability which may be incurred as a result of collecting such
information. A photocopy of this form will be as valid as an original thereof, even though said photocopy does
not contain an original writing of my signature.
I certify that all statements made in this application are true, complete, and correct to the best of my knowledge
and belief, and are made in good faith. I hereby certify that I meet the eligibility requirements in Article VI, §11
of the Illinois Constitution and Supreme Court Rule 39 (Appointment of Associate Judges).
Signature of Applicant
Date Signed
Email Address
Court of the
TWELFTH
TWELFTH
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Form 1.: I APPLICATION FOR APPOINTMENT TO THE (Administrative Office of the Illinois Courts)

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Completed 20 July 2020

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