Oregon State Bar, Regulatory Services, PO Box 231935, Tigard, OR 97281-1935
In The Supreme Court of the State of Oregon
In re: )
)
________________________________________________ __________________ ) Form A Resignaon
(Name) (Bar #) )
I,_________________________________________________________________________, declare that my residence address is:
(No. and Street) _________________________________________ (City) _____________________ (State) _____ (Zip Code) ____________,
and that I hereby tender my resignation from membership in the Oregon State Bar and respectfully request and consent to my
removal from the roster of those admitted to practice before the courts of this state and from membership in the Oregon State Bar.
I hereby certify that I am not charged in any iurisdiction with an offense that is a misdemeanor that may involve moral turpitude, a
felony under the laws of this state, or a crime punishable by death or imprisonment under the laws of the United States.
o I hereby certify that all client files and client records in my possession pertaining to active or current clients have been or will
be placed promptly in the custody of __________________________________________, a resident Oregon attorney, whose
principal office address is ________________________________________________________________________________,
who has agreed to serve as custodian to take possession of the files and take such further action as necessary to protect the
interests of the clients, and that all such clients have been or will be promptly notified accordingly, and that the following
arrangements have been made with regard to client files and records pertaining to inactive or former clients, if any:
_______________________________________________________________________________________________________
or
o I hereby certify that all client files and client records pertaining to active or current clients have been or will be placed promptly
in the custody of the Professional Liability Fund, which has agreed to take possession of the files and take such further action as
necessary to protect the interests of the clients. and that such clients have been or will be promptly notified accordingly, and that
the following arrangements have been made with regard to client files and records pertaining to inactive or former clients, if any:
_______________________________________________________________________________________________________
or
o I hereby certify that I have no client files or client records pertaining to active or current clients and that the following
arrangements have been made with regard to client files and records pertaining to inactive or former clients, if any:
_______________________________________________________________________________________________________
I agree to perform the dues of a resigned aorney set forth in BR 9.3 and that I may be held in contempt of court if I do not.
DATED at _________________, this ___________ day of _____________________, 20_____.
I HEREBY DECLARE THAT THE ABOVE STATEMENT IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF, AND THAT I
UNDERSTAND IT IS MADE FOR USE AS EVIDENCE IN COURT AND IS SUBJECT TO PENALTY FOR PERJURY.
________________________________________________________________________ (Signature of Member)
I, Helen Hierschbiel, Chief Execuve Ocer of the Oregon State Bar, do hereby cerfy that there are no inquiries or grievances
involving the above-named aorney under invesgaon by the Bar, no disciplinary proceedings are pending against the
aorney, and the aorney is not suspended, disbarred, or on probaon pursuant to BR 6.1 or BR 6.2.
Dated this _______day of ______________, 20_____. OREGON STATE BAR
B y : ____________________________________
Helen Hierschbiel, Chief Execuve Ocer
Dec/2020
Rule 13.6 Form A Resignaon
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regsvcs@osbar.org
