13-13565-360 - Renewal Application for Temporary Judge [REV 2/07/17]
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO
RENEWAL APPLICATION FOR TEMPORARY JUDGE
Use this form only if you are a temporary judge currently approved by the Superior Court of California, County of San Bernardino. (CRC, Rule 2.812)
CONTACT INFORMATION
Name: CA State Bar #: Date:
Business Address:
City/State/Zip:
Telephone: E-Mail:
Preferred method of contact: ☐Email ☐Telephone ☐Mail
QUALIFICATIONS
Pursuant to CRC, Rule 2.812(c), please provide certificates of completion and indicate type of training completed:
AREAS OF INTEREST
I am available to serve as a court-appointed temporary judge in the following case types:
I am available to serve at the following:
☐Morning
☐Afternoon
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☐M ☐T ☐W ☐Th ☐F ☐ San Bernardino
☐ Rancho Cucamonga
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☐ Victorville
☐ Barstow
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☐ All Locations
ACKNOWLEDGEMENT
I. I understand and acknowledge that the selection and appointment of a temporary judge is solely at the discretion of the
court for the purpose of assisting the public and does not constitute an employment relationship.
II. I am aware of and will comply with all provisions of the Code of Judicial Ethics and the California Rules of Court concerning
temporary judges.
III. I declare under penalty of perjury under the laws of the State of California that the foregoing, including statements made in
all attachments, is true and correct. I understand that any misstatement or omission of material fact may disqualify me
from serving as a temporary judge in this court.
WAIVER AND AUTHORIZATION FOR RELEASE OF INFORMATION
I have applied to be appointed as a temporary judge in the Superior Court of California, County of San Bernardino. I hereby authorize
the State Bar of California and the attorney-licensing authority in any other state where I am admitted to practice law to release to
an authorized representative of the court information regarding the following matters: (1) whether I am in good standing or am
otherwise authorized to practice law as a member of the State Bar of California or as an attorney in any other state where I am
admitted to practice law; (2) whether I have a record of discipline with the State Bar of California or with the licensing authority for
attorneys in any other state where I am admitted to practice law; and (3) whether any disciplinary investigation or proceeding is
pending against me by the State Bar of California or by the licensing authority for attorneys in any other state where I am admitted
to practice law.
Date:
(SIGNATURE OF APPLICANT)
Return completed application to: Temporary Judge Administrator
247 West Third Street, 11
th
Floor
San Bernardino, CA 92415 or via email: TempJudge@sb-court.org
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