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PetitionbyTransferUBEJan.2018

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Petition for Admission by TransferUBE
Page 1 of 2
Revision1.2018.sjcdms
Instructions for filing the Petition for Admission
By Transfer of Uniform Bar Examination Score Earned in Another Jurisdiction
Information you will need:
• Valid email address
• NCBE number
• Uniform Bar Examination (UBE) information detailing the date of the exam (taken within 36
months), the jurisdiction where you took the UBE, and, the Score (270 or higher).
• Surname Information - date, location, and reason for change
• Address history for previous 5 years, including dates
• Education history including all disciplinary actions and applicable records
• Employment (legal and other) history since the age of eighteen (18) with dates of employment,
employer reference, and reason for leaving
• Dates of all other applications and admissions to jurisdictions
• Dates of all Professional licenses applications (other than as an attorney)
• Appointed, Elected or Judicial appointments
• Professional discipline - other than attorney discipline - (charges, grievances, suspensions, etc.)
and applicable records
• Legal practice discipline (charges, grievances, suspensions, etc.) and applicable records
• Legal Proceedings (other than as representing counsel for civil, administrative, criminal, financial,
charges, grievances, suspensions, etc.) and applicable records
Documents you are required to attach to your Petition for Admission by Transfer of Uniform Bar Exam
Score Earned in another Jurisdiction:
Assemble the following documents.
• Confirmation issued from the National Conference of Bar Examiners (NCBE) that you requested
your UBE score transcript (showing a test date within 36 months and a score of 270 or higher) be
sent to Massachusetts.
• Law School Certificate
completed, signed and dated by your law school.
• MPRE Score Report You may request a copy of your MPRE Score Report by contacting the National
Conference of Bar Examiners (NCBE) via email at score.services@ncbex.org
or visit their website at
www.ncbex.org . You can also contact NCBE at 608-280-8550.
If you have not previously taken the MPRE, you must take and achieve a scaled MPRE score of
85 or greater prior to filing a Petition for Admission.
• Two Letters of Recommendation You must adhere to the strict protocol required for the Letters of
Recommendation. See the Guidelines for Letters of Recommendation
for additional
information.
Petition for Admission by TransferUBE
Page 2 of 2
Revision1.2018.sjcdms
• Certificates of Admission and Good Standing and Grievance Letters, if applicable.
Current (dated within 90 days of filing) Certificate(s) of Admission and Good Standing from the
highest judicial court of each state, district, territory, province or foreign country to which you are
admitted.
Current (dated within 90 days of filing) Grievance Letter from the grievance or disciplinary entity of
each state, district, territory, province or foreign country to which you are admitted, indicating that
there are no charges pending against you.
• Statement of Details to certain responses, if applicable.
• Records of any Legal Practice discipline (charges, grievances, suspensions, etc.), if applicable.
• Records of any Professional (other than attorney) discipline (charges, grievances,
suspensions, etc.), if applicable.
• Records of any Legal Proceedings (other than as representing counsel for civil, administrative,
criminal, financial, charges, grievances, suspensions, etc.), if applicable.
Filing Instructions:
• Complete and sign the Petition for Admission by Transfer of Uniform Bar Examination, and
verify that:
o
You meet the eligibility requirements under Supreme Judicial Court Rule 3:01, §3
;
o Each and every question, including dates, is fully answered;
o Complete details are provided;
o Each "yes” or “no” question has a “yes” or “no” response;
o Rider pages, if applicable, are typed with your name (printed) and signed; and,
o Pages requiring your signature are signed (photocopies are not accepted).
• Attach all required documents, riders and records to the Petition. Do not staple. Questions
regarding this may be directed to the Attorney Services Department of the Clerk for the County of
Suffolk at 617-557-1050.
• Filing Fee: $815.00 payable to the Commonwealth of Massachusetts in the form of a certified bank
check or money order. No personal or firm checks will be accepted.
• Send completed Petition, fee and all attachments by first class mail or in-person to:
Supreme Judicial Court for the County of Suffolk
Clerk Maura S. Doyle
John Adams Courthouse
One Pemberton Square, Suite 1300
Boston, MA 02108-1707
Notifications by E-Mail ONLY: The Supreme Judicial Court will e-mail notification when the Petition is
docketed and referred to the Board of Bar Examiners (BBE). The BBE will e-mail other pertinent
information accordingly.
Questions regarding these filing requirements may be directed to the Supreme Judicial Court Clerk’s
Office for Suffolk County at 617-557-1050, unless otherwise stated.
Questions regarding the content of the Petition for Admission may be directed to the Board of Bar
Examiners at (617) 482-4466.
Guidelines for Letters of Recommendation
Letters of Recommendation are required to provide pertinent information (past & present) to
determine the good character and fitness of any person Petitioning to practice law in
Massachusetts. See Board of Bar Examiners Rule V.
G
eneral Information:
• Letters of recommendation are required to be attached to every Petition for Admission. See below for the
number of letters of recommendation you are required to attach to your Petition for Admission (By
Examination: First Time or Re-Exam; By Transfer or Uniform Bar Examination; or By Motion).
• A Petition cannot not be filed without the required letters of recommendation.
• Letters of Recommendation must be written/dated within six months.
• Letters of Recommendation must be authored by a person (not a family member or relative) who knows
you well and in accordance with Rule 3:01, Sections 1.1.6, 1.2.5 and 1.2.6 (see below).
C
ontent Criteria: It is the obligation of each author to:
• Represent satisfactorily pertinent information about you;
• State the extent of their knowledge and familiarity with you;
• State specific facts, favorable or unfavorable, about your character and fitness;
• Provide their complete contact information (address, phone, and email);
• Sign the recommendation letter (photocopies are not accepted); and,
• Date the recommendation letter within six months.
Format Criteria: Each letter must be:
• Typed on plain (un-textured) white or letterhead paper using a 12-point font (no less);
• Addressed to the Members of the Board of Bar Examiners; at
Board of Bar Examiners
Edward Brooke Courthouse
24 New Chardon St., 1st Floor
Boston, MA 02114
• Composed in letter format not in memorandum format;
• Unique in content; and,
• Returned to the Petitioner (unsealed) to file with their Petition for Admission to the Supreme Judicial Court.
Required Number of Letters of Recommendation by Type of Petition for Admission:
• Petition by Examination (First Time and Re-Examination) requires two (2) letters authored by a person
(
not a family member or relative) who knows you well
• Petition by Transfer of Uniform Bar Exam requires two (2) letters authored by a person (not a family
member or relative) who knows you well
• Petition by Motion requires three (3) letters authored by a person who knows you well, and:
o One (1) letter authored by an attorney from Massachusetts; or, an attorney from your admitte
d
j
urisdiction; or, an attorney from where you live.
• Petition by Attorneys admitted in Canada requires three (3) letters authored by an attorney from
M
assachusetts; or, an attorney from the province or territory of Canada where you are admitted or last
practiced.
• Petition by Attorneys admitted in foreign countries requires five (5) letters:
o Three (3) letters authored by attorneys from your admitted jurisdiction; and,
o Two (2) letters authored by Massachusetts attorneys
.
Revision1.2018.sjcdms
Complete
and File with
your Petition
.
Responses
are MANDATORY.
Print
legibly.
Last Name: ________________________ First Name: _________________ Middle Name: ______________
Address: ____________________________________________________________________________________
City: ____________________________ State: _____________ Zip: _______ Zip Ext: ______
Country: _________________________
Primary Phone No.: _____________________________ E-mail: ______________________________
Personal Identifying Information (Not available to the public):
State of Birth: ________________________________
Date of Birth: _________________________________
Social Security No.: _____________________________
Indicate the required documents listed below that are attached to this mandatory Cover Sheet.
All signatory documents must be original. Photocopies are NOT accepted. Documents are NOT ACCEPTED
separately.
PETITION FOR ADMISSION requiring dates and original signatures (Page 2: your original signature and
the recommending attorney's original signature; Page 12; and, Page 13).
LAW SCHOOL CERTIFICATE (Photocopies are NOT accepted)
MPRE SCORE REPORT(indicating your NCBE Number).
UBE SCORE SERVICES CONFIRMATION issued by the NCBE.
(2)Two LETTERS OF RECOMMENDATION (signed and dated within six months. Photocopies are NOT accepted).
CURRENT (dated within 90 days) CERTIFICATE OF ADMISSION AND GOOD STANDING, if applicable, from
each jurisdiction to which you are admitted with applicable Grievance Letters (Photocopies are NOT accepted).
FEE in the form of a MONEY ORDER or BANK CHECK (NO Personal Checks) payable to the
Commonwealth of Massachusetts in the amount of $815.00.
City of Birth: ________________________________
Country of Birth: _____________________________
Parent Maiden Name: _________________________
NCBE No.: _________________________________
When did you sit for the
Uniform Bar Examination (UBE)? ______________
When did you sit for the MPRE? _______________
Graduating Law School : _____________________
What was your UBE Score: ______________________
What was your MPRE Score? ____________________
Law School Date of Graduation: __________________
Examination Information:
Petition For Admission To The Massachusetts Bar
By Transfer Of Uniform Bar Examination
Score
Earned In Another Jurisdiction
Cover Sheet
Supreme Judicial Court
For the County of Suffolk
John Adams Courthouse
One Pemberton Sq., Ste. 1300
Boston, MA 02108-1707
www.sjccountyclerk.com
Page 1 of 13
CIVIL NO.
SUFFOLK, SS.
IN THE MATTER OF
Full Name
PETITION
FOR ADMISSION TO THE BAR
OF THE COMMONWEALTH OF MASSACHUSETTS
BY TRANSFER OF UNIFORM BAR EXAMINATION SCORE
EARNED IN ANOTHER JURISDICTION
Pursuant to Supreme Judicial Court Rule 3:01, Section 1.2
Petition Filed _________________________________
(Court Use Only)
PetitionforAdmissionbyTransferUBErev01.2018
THE COMMONWEALTH OF MASSACHUSETTS
Suffolk, SS.
PETITION FOR ADMISSION TO THE BAR OF THE COMMONWEALTH OF MASSACHUSETTS
By Uniform Bar Examination Earned in Another Jurisdiction
I, ___________________________________________________ h
ereby petition for admission to the bar of the
Commonwealth by Uniform Bar Exam score earned in another Jurisdiction. I acknowledge this is an action at law and
subject to public access.
*
I further acknowledge
that I have
received notice that certain public case information
may
be provided electronically to third parties after the
execution of a Non-Disclosure Agreement.
I represent that I am of good moral character and over the age of eighteen years, having been born
on ____________________________. I further represent that I have achieved a passing scaled score of the Uniform
Bar Examination held on ____________________ at _______________
with a UBE Score of___________________.
I request that I be examined for admission as an attorney. After having achieved a passing Uniform Bar Examination
score, passed the Massachusetts Law Component, and, having been found to be of good moral character and of
sufficient acquirements and qualifications, I request to be admitted as an attorney.
Petitioner Signature: __________________________________________________________________
Address: ___________________________________________________________________________
City: ___________________ State: _____________ Zip: ___________ Ext: _____________
E-mail Address: _________________________________ Telephone No.: ______________________
NCBE No.: __________________________
Date: ________________________________
RECOMMENDATION OF A MEMBER OF THE BAR OF THE COMMONWEALTH OF MASSACHUSETTS OR OF
ANY STATE, DISTRICT OR TERRITORY OF THE UNITED STATES
(Supreme Judicial Court Rule 3:01, subsection 1.2.1)
I,____________________________________________________ , an attorney of the bar of ___________respectfully
recommend that the foregoing petition be granted, and certify that the petitioner is of good moral character.
Attorney Signature: ____________________________________________________________________
Business Address: ____________________________________________________________________
City: ___________________ State: _____________ Zip: ___________ Ext: _______
E-mail Address: _________________________________ Telephone No.: ________________________
Attorney Registration No.: _________________________ Registration Status: ____________________
Date: ________________________________
In accordance with M.G.L. c. 93H, personal identifying information is safeguarded to protect the risk of identity theft or fraud.
Page 2 of 13
Supreme Judicial Court For Suffolk County
Suffolk, SS Supreme Judicial Court For Suffolk County
In the matter of_________________________________________________________
(Petition for Admission to the Bar of the Commonwealth of Massachusetts)
PETITIONER'S STATEMENT
Contact Information
Last Name: ________________________ First Name: _________________ Middle Name: ___________
Address: ________________________________________________________________________________
Address: ________________________________________________________________________________
City: ___________________________ State: _____________ Zip: _______ Zip Ext: ______
Country: ________________________
Primary Phone No.: _____________________________ E-mail: ______________________________
Personal Information
City of Birth: ________________________________ State of Birth: ___________________________
Country of Birth: _____________________________
Date of Birth: ________________________________ Social Security No.: _______________________
NCBE No.: _________________________________
Surname Information
Have you ever been known by any other name? Yes __________ No __________
If yes, provide the following former name information:
Last Name: _________________________ First Name: _________________ Middle Name: __________
Date of Name Change: ________________________
Reason for Change: __________________________ Place of Name Change: ___________________
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
(last four digits: xxx-xx-1234)
(i.e. Marriage) (i.e. City, State)
Do you have additional surnames? Yes __________ No __________
The Commonwealth of Massachusetts
Page 3 of 13
Parental Information
Parent One:
Last Name: _____________________ First Name: _________________ Maiden Name: _________
Address: ____________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Parent Two:
Last Name: _____________________ First Name: _________________ Maiden Name: _________
Address: ____________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Residential Information
State every residence you have had during the last five years. Begin with your current residential address:
(a) Address: _________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
From: ________________________________ To: __________________________________
(b) Address: _________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
From: ________________________________ To: __________________________________
(c) Address: _________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
From: ________________________________ To: ____________________________________
(d) Address: _________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
From: ________________________________ To: ____________________________________
(e) Address: _________________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
From: ________________________________ To: _____________________________________
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
Page 4 of 13
Education
Law School: Provide your law school education. Complete the section below. Do not leave blank.
(a) Law School Conferring Degree: __________________________________________________________
Law School Address: __________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Attendance From: ____________ Attendance To: ____________ Degree Awarded: ____________
Other Education: Colleges and universities. Complete the section below. Do not leave blank.
(a) Name of School: ___________________________________________________________________
School Address: ___________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Attendance From: _____________________ Attendance To: __________________________
Degree Awarded: _____________________
(b) Name of School: ___________________________________________________________________
School Address: ___________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Attendance From: _______________________
Attendance To: __________________________
Degree Awarded: _______________________
Academic Information: Do not leave blank.
Have you ever been reprimanded, sanctioned, disciplined, suspended, or expelled from a college,
university or law school? Yes __________ No __________
If yes, provide a statement of details.
(b) Secondary Law School: ________________________________________________________________
Law School Address: __________________________________________________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Attendance From: ____________ Attendance To: ____________ Degree Awarded: ____________
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
Page 5 of 13
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
Employment
Have you ever been a member of the Armed Services? Yes __________ No __________
If yes, state the type of discharge. If dishonorably discharged, state circumstances surrounding your release
and the details thereof, where the record can be obtained, your service number and rank, and the branch and
dates of actual service. ____________________________________________________________________
________________________________________________________________________________________
Page 6 of 13
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
General Employment
List any employment you have held since your 18th birthday. Include self-employment, part or full time
employment, legal employment, and if applicable, any military service. Begin with your current employment.
(a) Name of Employer/Firm: __________________________________________________________________
(i.e., administrative, medical, sales, retail, etc.)
Position Held: ___________________________________________________________________________
Employed From: _____________________________ Employed To: _______________________________
Reason for Leaving: ______________________________________________________________________
Employer Reference: _____________________________________________________________________
Provide a reference to verify any firms, businesses, or employers that no longer exist.
Address: ________________________________________________Website:________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Nature of Business: _______________________________________________________________________
(b) Name of Employer/Firm: __________________________________________________________________
(i.e., administrative, medical, sales, retail, etc.)
Position Held: ___________________________________________________________________________
Employed From: _____________________________ Employed To: _______________________________
Reason for Leaving: ______________________________________________________________________
Employer Reference: _____________________________________________________________________
Provide a reference to verify any firms, businesses, or employers that no longer exist.
Address: ________________________________________________Website:________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Nature of Business: _______________________________________________________________________
Employment Information
Have you ever been terminated, or resigned in lieu of termination, from any position?
Yes _____ No _____
If yes, attach a statement of details with applicable records.
(c) Name of Employer/Firm: __________________________________________________________________
(i.e., administrative, medical, sales, retail, etc.)
Position Held: ___________________________________________________________________________
Employed From: _____________________________ Employed To: _______________________________
Reason for Leaving: ______________________________________________________________________
Employer Reference: _____________________________________________________________________
Provide a reference to verify any firms, businesses, or employers that no longer exist.
Address: ________________________________________________Website:________________________
(i.e., 0000 Sample Ave., Sample Building, City, State, Zip and Country)
Nature of Business: _______________________________________________________________________
Other Applications for Admission
Have you previously applied for admission as an attorney in Massachusetts? Yes ______ No ______
State every jurisdiction you have applied for admission to the Bar. Include admission by examination, on
motion, any other manner of application for admission, and applications for reinstatement or withdrawal. Do not
leave blank. You must indicate if a response is not applicable.
Date of Application: _____________________ Application Type: _________________________
(Examination, Motion, etc.)
Dates of Examination: ___________________ Result of Examination: _____________________
(pass, fail, etc.)
Disposition: ___________________________
(b) Jurisdiction: ____________________________
Date of Application: _____________________ Application Type: _________________________
(Examination, Motion, etc.)
Dates of Examination: ___________________ Result of Examination: _____________________
(pass, fail, etc.)
Disposition: ___________________________
(c) Jurisdiction: ____________________________
Date of Application: _____________________ Application Type: _________________________
(Examination, Motion, etc.)
Dates of Examination: ___________________ Result of Examination: _____________________
(pass, fail, etc.)
Disposition: ___________________________
(d) Jurisdiction: ____________________________
Date of Application: _____________________ Application Type: _________________________
(Examination, Motion, etc.)
Dates of Examination: ___________________ Result of Examination: _____________________
(pass, fail, etc.)
Disposition: ___________________________
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
(a) Jurisdiction: ____________________________
Page 7 of 13
Las
t Name: ___________________________________
First
Name:
___________________________________
Middle Name
:
____________________
Other Admissions
State each jurisdiction and court in which you have been admitted to practice law and provide the requested
information below. Do not leave blank. You must indicate if a response is not applicable. Attach a Certificate of
Admission and Good Standing with applicable Grievance letter (dated within 90 days of this Petition).
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
(a) Jurisdiction: _________________________ Date of Admission: __________________________
Bar Registration No: _________________________
If applicable, which Court(s) within this Jurisdiction are you admitted? ___________________________
Where have you engaged in the actual practice or teaching of law? _____________________________
What is the nature of your practice or teaching of law? _______________________________________
The nature of your practice or teaching of law has continued
From: _________________ To: _______________
(b) Jurisdiction: _________________________ Date of Admission: __________________________
Bar Registration No: _________________________
If applicable, which Court(s) within this Jurisdiction are you admitted? ___________________________
Where have you engaged in the actual practice or teaching of law? _____________________________
What is the nature of your practice or teaching of law? _______________________________________
The nature of your practice or teaching of law has continued
From: _________________ To: _______________
(c) Jurisdiction: _________________________ Date of Admission: __________________________
Bar Registration No: _________________________
If applicable, which Court(s) within this Jurisdiction are you admitted? ___________________________
Where have you engaged in the actual practice or teaching of law? _____________________________
What is the nature of your practice or teaching of law? _______________________________________
The nature of your practice or teaching of law has continued
From: _________________ To: _______________
Has your authorization to practice in any Jurisdiction/Court ever been interrupted since the date of your
Admission? Yes __________ No __________
If yes, attach a statement of details with applicable records.
Page 8 of 13
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
Professional Information
Have you ever filed any application for an official position or for professional licensure, other than as an
attorney, that required proof of good character? Yes __________ No __________
If yes, provide the following information:
(a) Official License/Position: _____________________ Licensing Authority: __________________________
(i.e., CPA)
Date of Application: ________________________
Dates of Examination: ______________________ Result of Examination: _______________________
(pass, fail, etc.)
Disposition: _______________________________ Date of License/Position: _____________________
(b) Official License/Position: ____________________ Licensing Authority: _________________________
(i.e., CPA)
Date of Application: ________________________
Dates of Examination: ______________________ Result of Examination: _______________________
(pass, fail, etc.)
Disposition: ______________________________ Date of License/Position: _____________________
Have
you ever held any license, othe
r than as an
attorney, wh
ich required
proof of goo
d character?
Yes __________ No _________
If yes, provide the follo
wing information:
(a) License Type: _____________________________ State: _____________________________________
Authorizing Office: _____________________________________________________________________
Office Address: ________________________________________________________________________
Date License was Granted: __________________ License Status: _____________________________
(b) License Type: _____________________________ State: _____________________________________
Authorizing Office: _____________________________________________________________________
Office Address: ________________________________________________________________________
Date License was Granted: __________________ License Status: _____________________________
Have
you ever held any elected, app
ointed or jud
i
cial off
i
ce?
Yes ____
______ No ________
__
If yes, provide the follo
wing information:
(a) Elected/Appointed/Judicial Office: _________________________________________________________
(i.e., 1st Circuit Court Clerk, etc.)
Office Address:___________________________________________________________________________
(i.e., ~0000 Sample Ave., Sample Building, City, State, Zip and Country)
Served From: ______________________________ Served To: _______________________________
Reason for Leaving: ____________________________________________________________________
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
Page 9 of 13
Last Nam
e: ___________________________________
First
Name:
___________________________________
Middle Name
:
____________________
Professional Information (continued)
Have any charges, grievances or complaints ever been made concerning your conduct as a member of any
profession, other than an attorney, or as a holder of any public office? Yes ________ No ________
If yes, provide the following information:
(a) License
Type: _____________________________
State: ____________________________
Authorizing
Office: ___
__________________________________________________________
Dates of Complaint: ____________________
Complaint Status: ____
___________________
Reason for the Complaint: ________________________________________________________
(b) License
Type: _________________________
State: _____________________________
Authorizing
Office: __
___________________________________________________________
Dates of Complaint: ____________________
Complaint Status: ____
____________________
Reason for the Complaint: ________________________________________________________
Have any of your licenses or positions ever been suspended or revoked as a member of any profession,
other than a
n attorney, or as a holder of any public office?
Yes ________ No ________
If yes, provide the following information:
(a) License/
Position: __
_________________________
State: ____________________________
Authorizing
Office: ___
__________________________________________________________
Date of Suspension/Revocation: __
_________
License Stat
us: ______
__________________
Reason for Action Take
n: _______
_________________________________________________
Attach a stat
ement of details with app
licable re
cor
ds.
(b) License/
Position: __
_________________________
State: ____________________________
Authorizing
Office: ___
__________________________________________________________
Date of Suspension/Revocation: ___________ License Status: ________________________
Reason for Action Taken: __________________________________________________
Attach a statement of details with applicable records.
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
Page 10 of 13
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
Practice of Law Information
Have
you ever been cha
r
ged with or been the su
bject of any investigation
pertaining t
o the unauth
orized
practice of
law?
Yes
________
No ________
If yes, attach a statement of details
with applica
ble records.
Have any charges, grievances or complaints ever been made concerning your conduct as an attorney?
Yes ________ No ________
If yes, attach a statement of details with applicable records.
Have you ever been disbarred, suspended, reprimanded, censured, admonished or otherwise disciplined or
disqualified as an attorney? Yes ________ No ________
If yes, attach a statement of details with applicable records.
Legal Proceedings
Have you ever been a party on either side in a civil action, or a proceeding involving a claim of fraud,
conversion, breach of fiduciary duty, professional malpractice or other wrongful conduct?
Yes ________ No ________
If yes, attach a statement of details with applicable records.
Have you ever been a party, other than as representing counsel, in any other legal or administrative
proceedings? Yes ________ No ________
If yes, attach a statement of details with applicable records.
Have you ever been charged with or been the subject of any investigation for a felony or misdemeanor other
than a minor traffic charge? Yes ________ No ________
If yes, attach a statement of details with applicable records.
Have you ever been adjudged bankrupt or insolvent? Yes ________ No ________
If yes, attach a statement of details with applicable records.
Are there any unsatisfied judgments or any court orders of continuing effect against you?
Yes ________ No ________
If yes, attach a statement of details with applicable records. Include names and addresses of creditors,
amounts, dates and the nature of the debts, judgments or any non-compliance with court orders.
You must respond to all questions. You must indicate if a response is not applicable. The Petition for
Admission will be delayed without any further action for failure to respond.
ATTACH RIDER PAGE(S) IF NECESSARY. Information must be provided in same format as above.
Page 11 of 13
Las
t Name: ___________________________________
First
Name:
___________________________________
Middle Name
:
____________________
Have you, if applicable, attached current Certificate of Admission and Good Standing with Grievance letter
from every jurisdiction and court you are admitted to? Yes _____ No_____
•
Chronology beginning with most recent issue;
•
Narrative with dates stating the facts;
•
Names and locations of court, tribunal or record of
authority (if any);
•
Case numbers, references to court records or account numbers;
•
Names and addresses of all persons and parties involved,
including all counsel; and,
•
The current disposition of the matter.
Certificate
I understand that I am obligated, by the Board of Bar Examiners Rule V.1.2., to file in writing with the Clerk's Office
of the Supreme Judicial Court for the County of Suffolk any changes or additions to answers that I have made on
this Petition.
I understand that this obligation shall continue until I am admitted to the practice of law in the Commonwealth of
Massachusetts, or until such time as my Petition is withdrawn or denied by the Supreme Judicial Court.
I understand that my failure or refusal to supply information deemed relevant by the Board of Bar Examiners may
be grounds for denial of a recommendation for admission. I, the Petitioner, certify that each of the foregoing
answers are true, complete and candid and that I have not altered the wording of any question.
I further certify that I have answered all questions and have attached rider pages with statements of details for any
applicable response within this Petition.
Petitioner’s Signature: _________________________________________ Date: _____________________
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
________________
________________
________________
Requirements
When did you sit for the Uniform Bar Examination8%(?
Where did you sit for the UBE?
What was your U%E Score?
When did you request the National Conference of Bar Examiners transfer your
UBE Transcript directly to Massachusetts?
Have you attached the UBE Score Services Confirmation issued by the NCBE? Yes _____ No____
When did you sit for the Multistate Professional Responsibility Examination (MPRE)? ________________
What was your MPRE Score? ________________
Have you attached an official or unofficial MPRE Score Report? Yes _____ No_____
Have you attached your completed Law School Certificate? Yes _____ No_____
Have you attached the requisite (dated within six months) letters of recommendation? Yes _____ No_____
Page 12 of 13
If you answered No for any requirement, provide an explanation. ________________________________
Statement of Details
All responses within this Petition for Admission are mandatory. The Petition for Admission will be delayed without
any further action for failure to respond. The statement of details, as required by certain responses, must provide
the following:
mm/dd/yyyy)
Commonwealth of Massachusetts
Board of Bar Examiners
AUTHORIZATION
I, _______________________________________________________________________________
First Name Middle Name Last Name
residing at:
Address Line 1: ___________________________________________________________________
Address Line 2: ___________________________________________________________________
City: ___________________________ State: _____________ Zip: _______ Zip Ext: ______
and born on _________________________, having filed a Petition for admission to the bar of the
(Date of Birth)
Commonwealth, hereby consent to have an investigation made as to my moral character, professional
reputation, and fitness for the practice of law.
I hereby authorize every person, firm, company, corporation, governmental agency, law enforcement
a
gency, court, bar association, or institution having control of any documents or records regarding charges
or complaints filed against me, including any complaints expunged by law, whether formal or informal,
pending or closed, or any other pertinent data to provide th
em to the Massachusetts Board of Bar
Examiners.
Petitioner’s Signature: __________________________________________ Date: ____________________
Page 13 of 13
Last Name: ___________________________________ First Name: ___________________________________ Middle Name: ____________________
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PetitionbyTransferUBEJan.2018

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Completed 25 October 2019

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