Fillable Intern Appearance Permission (other Than State Agency) (Vermont Judiciary)

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Intern Appearance Permission (other Than State Agency) (Vermont Judiciary)

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900-00029 - Intern Appearance Permission (Not State Agency) (01/2018) Page 1 of 2
STATE OF VERMONT
SUPERIOR COURT
DIVISION
Unit
Docket No.:
Plaintiff
vs.
Defendant
CONSENT AND PERMISSION FOR LEGAL INTERN
TO APPEAR AS LEGAL COUNSEL
Legal Intern’s Name (please print): _______________________________________
Consent of the Client
I hereby consent to the appearance of the Legal Intern named above to appear as legal counsel on my behalf before
the Court in the matter referenced above in accordance with the Rules of Admission to the Bar of the Vermont
Supreme Court.
☐ I do ☐ I do not
authorize the Legal Intern to appear without the Supervising Attorney at court
appearances not involving a contested matter.
Date: _____________ Client’s Signature: _____________________________________
Client’s Printed Name: __________________________________
Consent and Certification of the Supervising Attorney
I hereby consent to the appearance of the Legal Intern named above to appear as legal counsel before the Court in
this matter on behalf of the Client named above. I certify that I have complied with, and will continue to comply with,
the Rules of Admission to the Bar of the Vermont Supreme Court as they apply to the appearance of the Legal Intern
in this matter, including the duties of supervision.
I also certify that I have in force professional liability insurance that
will cover the actions of the Legal Intern in this matter.
Date: _____________ Attorney’s Signature: _____________________________________
Attorney’s Printed Name: __________________________________
VERMONT SUPREME COURT
OFFICE OF ATTORNEY LICENSING
32 CHERRY STREET, SUITE 213
BURLINGTON, VT 05401
JUD.ATTYLICENSING@VERMONT.GOV
900-00029 - Intern Appearance Permission (Not State Agency) (01/2018) Page 2 of 2
Certification and Agreement of the Intern
I certify that I have complied with, and will continue to comply with, the Rules of Admission to the Bar of the Vermont
Supreme Court as they apply to my appearance as legal counsel in this matter.
I hereby agree to be bound in this
matter by the Vermont Rules of Professional Conduct.
Date: _____________ Signature: _____________________________________
Permission of the Court
The Legal Intern named above is hereby granted permission to appear as legal counsel in this matter on behalf of the
Client named above. The Legal Intern is hereby authorized to conduct in this matter the activities of a legal intern as
specified in the Rules of Admission to the Bar of the Vermont Supreme Court in compliance with the conditions
specified in those Rules.
☐ I do ☐ I do not
authorize the Legal Intern to appear without the Supervising Attorney at court
appearances not involving a contested matter.
Date: _____________ Signature: _____________________________________
Questions regarding an Intern's eligibility should be directed to the Office of Attorney Licensing at (802) 859-3000.
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Intern Appearance Permission (other Than State Agency) (Vermont Judiciary)

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Completed 30 July 2020

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