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THE NORTH CAROLINA STATE BAR STATEMENT REGARDING PRO (North Carolina State Bar)

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THE NORTH CAROLINA STATE BAR
STATEMENT REGARDING
PRO BONO SUPERVISION
FOR EMERITUS OR OUT OF STATE ATTORNEY
The below named active North Carolina State Bar Member, who is employed by a nonprofit
corporation qualified to render legal services pursuant to G.S. 84-5.1, hereby agrees to supervise as
“responsible lawyer” the attorney named below:
Petitioner for:
PRO BONO EMERITUS STATUS:_________________________________________________
OR
OUT-OF-STATE PRO BONO STATUS:_____________________________________________
Name____________________________________________________________________________
N.C. Bar # _________________
Employer_________________________________________________________________________
Title:_____________________________________________________________________________
Address __________________________________________________________________________
City __________________________________ State _____________ Zip _____________________
Phone # __________________________________________________________________________
E-mail address______________________________________________________________________
Signature______________________________________________ Date:_______________________
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THE NORTH CAROLINA STATE BAR STATEMENT REGARDING PRO (North Carolina State Bar)

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Completed 20 July 2020

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