BACKGROUND INFORMATION
1. Are you now or have you ever been named as a defendant in any lawsuit or
arbitration proceeding involving allegations of fraud, misappropriation of funds,
misrepresentation or breach of fiduciary duty?
Yes No
If you answer "Yes" you must attach to this application:
(a) A written statement summarizing the details of each incident,
(b) A copy of the Petition, Complaint or other document that commenced the
lawsuit or arbitration, and
(c) A copy of the official document, which demonstrates the resolution of the
charges or any final judgment.
2. Have you or any business in which you are or were an owner, partner, officer or
director ever been involved in an administrative proceeding regarding any
professional or occupational license?
Yes No
"Involved" means having a license censured, suspended, revoked,
canceled, terminated; or, being assessed a fine, placed on probation or
surrendering a license to resolve an administrative action.
"Involved" also means having a license application denied or the act of
withdrawing an application to avoid a denial. You may exclude
terminations due solely to noncompliance with continuing education
requirements or failure to pay a renewal fee.
If you answer "Yes" you must attach to this application:
(a) A written statement identifying the type of license and explaining the
circumstances of each incident,
(b) A copy of the Notice of Hearing or other document that states the charges and
allegations, and
(c) A copy of the official document, which demonstrates the resolution of the
charges or any final judgment.
3. Have you ever been convicted of, or are you currently charged with committing a
crime?
Yes No
"Crime" includes a misdemeanor, felony or a military offense. You may
exclude misdemeanor traffic citations and juvenile offenses.
"Convicted" includes, but is not limited to, having been found guilty by
verdict of a judge or jury, having entered a plea of guilty, by Alford plea,
nolo contendere, or having been given probation, a suspended sentence or
a fine.
If you answer "Yes" you must attach to this application:
(a) A written statement explaining the circumstances of each incident,
(b) A copy of the charging document, and
(c) A copy of the official document that demonstrates the resolution of the charges
or any final judgment.
SUPREME COURT OF NEVADA APPLICATION FOR SETTLEMENT JUDGE Page 5 of 7 Adopted by Order 3/10/06