Fillable Rev. 04/21/2014 PRO HAC VICE ADMISSION REGISTRATION STATEMENT (North Carolina State Bar)

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Rev. 04/21/2014 PRO HAC VICE ADMISSION REGISTRATION STATEMENT (North Carolina State Bar)

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1
PO Box 25908
Raleigh, North Carolina 27611
Telephone: (919) 828-4620
Rev. 04/21/2014
PRO HAC VICE ADMISSION REGISTRATION STATEMENT
UPDATE FORM
(FOR NEW SPONSORING ATTORNEY)
To Update a Prior Pro Hac Vice Admission Registration Statement
(When the NC sponsoring attorney has withdrawn and a new NC attorney has been appointed.)
1. Out of State Attorney Name: _____________________________________
2. Previous North Carolina State Bar member (Responsible Attorney) Information
Name: _______________________________________
Phone #: _______________________________________
3. New North Carolina State Bar Member (Responsible Attorney) Information
Name: __________________________________________________________
NC Bar #: _______________________________________________________
Address (as listed with State Bar): ____________________________________
_________________________________________________________
Phone #: ____________________Email:________________________________
4. North Carolina Case Information
(Please enclose new motion and pro hac vice order)
File Name: _______________________________________________
File Number: _____________________________________________
5. Responsible Attorney Verification.
By signing below, the responsible attorney acknowledges that truth of the foregoing statements
and agrees to notify the State Bar of the final determination of the court proceeding.
_________________________________ ___________________________
Signature of NC Attorney Date
For Office Use Only:
PHV-___________
Received: ___________________ Date Entered: ________________ Date acknowledged: __________
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Rev. 04212014 PRO HAC VICE ADMISSION REGISTRATION STATEMENT (North Carolina State Bar)

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Completed 20 July 2020

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