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The North Carolina State Bar Board of Legal (North Carolina State Bar)

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1
The North Carolina State Bar
Board of Legal Specialization
217 E. Edenton Street
PO Box 25908 (27611)
Raleigh, NC 27601
(919) 828-4620
www.nclawspecialists.gov
2020
Application for Recertification as a
Specialist
Board Members
Larry H. Rocamora, Chair
Durham
Kimberly R. Coward, Vice-Chair
Cashiers
Patti Head
Raleigh
Laura V. Hudson
Raleigh
Everett (Vic) Knight
Raleigh
Matthew J. Ladenheim
Huntersville
Robert A. Ponton
Raleigh
Jan E. Pritchett
Greensboro
Nancy S. Ray
Greenville
Brian P.D. Oten, Director
Denise E. Mullen, Assistant Director
Lanice V. Heidbrink, Executive Assistant
Sheila Saucier, Certification Coordinator
2
INSTRUCTIONS
North Carolina State Bar Application for Recertification as a Specialist
1. Standards - Read the North Carolina Plan of Legal Specialization (located at 27 N.C. Admin. Code 1D.1700 et
seq.), the minimum standards for certification of specialists (27 N.C. Admin. Code 1D.1720), and the standards
for certification in your specialty area (27 N.C. Admin. Code 1D.2100-.3300). These standards can be found in
the North Carolina Administrative Code and are republished in the North Carolina State Bar Lawyer’s Handbook
and on our website, www.ncbar.gov .
2. Fees - A filing fee of $250 must accompany this application. All checks should be payable to the North Carolina
State Bar Board of Legal Specialization (the Board). Rejection or withdrawal of an application does not entitle
an applicant to a refund of the fee or any part of the fee. Late applications received between September 1,
2020, and September 30, 2020, will be accepted with an additional $250 late filing fee. Applications received
after September 30, 2020, will not be accepted.
3. Filing Timeliness - The completed application shall be considered timely filed if the application is delivered to
the offices of the North Carolina State Bar before 5:00 p.m. on August 31, 2020 or is postmarked no later than
August 31, 2020.
4. INSTRUCTIONS FOR COMPLETING APPLICATION
A. PLEASE ANSWER EACH QUESTION. If additional space is needed to answer a question, please
attach sheets to the application.
B. WAIVER OF STRICT COMPLIANCE – If an applicant cannot meet the standard for substantial
involvement, CLE, or peer review for a specialty, the applicant may request a waiver of strict
compliance. To do so, you must complete the Request for a Waiver of Strict Compliance Form,
available on the website, http://www.nclawspecialists.gov/for-lawyers/forms/, and submit the form with
your application. Please email Lanice Heidbrink (lheidbrink@ncbar.gov) with any questions.
C. REFERENCES - Each applicant for recertification is asked to submit the names and addresses of
six references in support of his or her application. Please check your anticipated specialty’s standards
for any additional requirements regarding peer reference eligibility. It is preferred that references have
experience in or are substantially involved in the specialty as that term is defined in the certification
standards.
The extent of a reference’s involvement in the applicable specialty and relationship to the
applicant will be considered in the evaluation process. All references will be contacted by the North
Carolina State Bar Board of Legal Specialization or its representatives and be asked to complete written
peer reference statements. A minimum of three peer reference statements must be returned to the
Board for an application to advance. Reference forms will be sent to the email address you provide;
please confirm with each reference that the email address you provide is correct. Reference forms can
be mailed to listed references upon request of the applicant and provision of an accurate mailing
address. The Board, or its representatives, may contact, in person or by telephone, any reference
listed by an applicant, or any lawyer or judge qualified to evaluate the applicant’s competence and
qualification in the specialty area. You are encouraged to advise your peer references that you have
listed them on this application and to confirm that they are willing to respond to a peer reference request.
D. SUPPLEMENTAL APPLICATION FORMS – Please note that the specialties marked with an
asterisk (*) on page four require a supplemental application form to be submitted with the application.
The forms are labeled by specialty and are available on the website:
http://www.nclawspecialists.gov/for-lawyers/forms/.
E. INACTIVE STATUS – If your State Bar membership status is inactive or retired, please contact
lheidbrink@ncbar.gov for instructions.
5. Confidentiality – All information contained in the application, including all supporting documents, peer
reference information, and statements shall be confidential unless otherwise dictated by the North Carolina
Public Records Act. Such information, however, shall be available for use by the Board of Legal Specialization,
the appropriate specialty committee, staff, or any appropriate body or tribunal in the event of an appeal.
3
6. Processing of Completed Applications – Only completed applications will be reviewed by the Board of Legal
Specialization. Each applicant will be notified by email of acceptance or rejection of his or her application. An
application is incomplete if it does not include complete answers to every question on the application, the required
list of peer references, and copies of all documents requested in the application.
7. Filing Application – Applications should be delivered to the State Bar or postmarked no later than 5:00 p.m.
on August 31, 2020 and addressed to:
North Carolina State Bar Board of Legal Specialization
Attn: Brian P.D. Oten, Director
217 E. Edenton Street
PO Box 25908 (27611)
Raleigh, NC 27601
Or hand delivered to: 217 E. Edenton Street, Raleigh, 27601
4
Name as Listed with North Carolina State Bar Membership
Date Admitted to the North Carolina State Bar
Preferred Name for Specialization Directory North Carolina State Bar Number
I. Contact and Employer Information
1
A.
1
IMPORTANT: Any updates reported to State Bar membership will not automatically update in the
specialization database. Changes must be reported directly to specialization staff.
Please check the specialty for which you are applying:
Appellate Practice* Family Law
Business Bankruptcy Law Immigration Law
Consumer Bankruptcy Law Privacy and Information Security Law
Criminal Law - State* Commercial Real Property Law
Criminal Law - Federal/State* Residential Real Property Law
Criminal Law - Juvenile Delinquency Social Security Disability Law*
Elder Law Trademark Law
Estate Planning and Probate Law Utilities Law
Workers’ Compensation Law*
* Supplemental Application Form Required (available at
http://www.nclawspecialists.gov/for-lawyers/forms/ )
Preferred Address for Specialization Database/Directory
City
State Zip Code Telephone
Email Address
Current Firm or Employer Name and Address
City
State Zip Code Telephone Number of
Lawyers with
Firm or Employer
The North Carolina State Bar
Board of Legal Specialization
2020 APPLICATION FOR RECERTIFICATION
5
B.
If you have been certified as a specialist by any organizations other than the North Carolina State Bar
Board of Legal Specialization, list the name and date of each certification and identify the certifying
organization:
Name of Certification Date of Certification Certif
y
in
g
Or
g
anization
II. States of Licensure
List all states, other than North Carolina, in which you are licensed to practice law.
Apply for a letter of good standing from each state listed below. Please do not list or provide a letter of good
standing for North Carolina. Request that the letter be mailed directly to the North Carolina Board of Legal
Specialization.
* If not a member in good standing,
provide an explanation.
III.
Professional Conduct
2
A. During the five years since your last certification, have you been disbarred, suspended from practice,
reprimanded, censured, sanctioned or otherwise disciplined or disqualified (including the revocation of a pro
hac vice admission, disqualification from representation of a client because of misconduct, or a disability or
administrative suspension) by a licensing agency, court, or professional organization for conduct as a lawyer
or as a member of any profession or organization, or as a holder of any office, public or private? Include court
orders and letters of warning and caution in your response.
Yes No
B. Are there any such actions pending (unresolved) against you?
Yes No
C. If you answered “yes” to either question above, for each action (pending or resolved), state the following:
(1) The disciplinary agency, court, or professional organization: _______________________________
(2) Date of notice to you if unresolved or date of discipline, sanction, disqualification, or other such action, if
resolved:
(3) If discipline, sanction, or disqualification was issued, attach a copy of the order or record of such action
along with a written explanation.
2
Documentation of disciplinary history does not have to be attached to this application if you send a
letter to the relevant disciplinary agency, court or professional organization requesting that the
documentation be sent directly to the Board of Legal Specialization. A copy of the letter making such
request must be attached to this application.
State Date of Admission Membership Number Member in Good Standing?
Yes No*
State Date of Admission Membership Number Member in Good Standing?
Yes No*
6
D. List all malpractice actions filed against you in the five years since your last certification regardless of whether
the action is currently pending or resolved. With regard to each action, state or provide the following (attach
additional sheets if necessary):
(1) Name of action:
(2) Date of filing and venue of action:
(3) Brief summary of allegations and your response or defense:
(4) Explanation of status or resolution:
IV. Substantial Involvement
Instructions: Please review the substantial involvement requirements for your specialty located in the
administrative code provisions listed in the instructions. To qualify for recertification, the applicant’s practice
in the area of law for which recertification is sought must equal to or exceed the substantial involvement
requirements set forth in the standards for the applicable specialty. If you do not meet the requirements, in
order for your application to be processed, you must complete a Request for a Waiver of Strict Compliance
Form which can be found on the website, http://www.nclawspecialists.gov/for-lawyers/forms/. The waiver
request is subject to specialty committee and board approval. Please email Lanice Heidbrink
(lheidbrink@ncbar.gov) with any questions.
Total number of years you have practiced in this specialty area: __________
2016
Approximate number of hours (do not use percentages) devoted to the specialty practice area: __________
Brief description of substantive legal work or practice equivalent:
2017
Approximate number of hours (do not use percentages) devoted to the specialty practice area: __________
Brief description of substantive legal work or practice equivalent:
2018
Approximate number of hours (do not use percentages) devoted to the specialty practice area: __________
Brief description of substantive legal work or practice equivalent:
2019
Approximate number of hours (do not use percentages) devoted to the specialty practice area: __________
Brief description of substantive legal work or practice equivalent:
7
2020 to date
Approximate number of hours (do not use percentages) devoted to the specialty practice area: __________
Brief description of substantive legal work or practice equivalent:
* Attach additional pages if necessary.
V. Continuing Legal Education
Your CLE record will be obtained by staff from the North Carolina State Bar CLE Department. The full calendar years of
2016 through 2020 will be reviewed for CLE compliance. To view your CLE history online go to www.nccle.org. Please
attach a page listing any courses that you plan to take after filing this application as well as any of the following that you
would like to be considered for specialization credit (not otherwise included in your North Carolina State Bar CLE record;
see 27 N.C. Admin. Code 1D.1905 for alternatives to the CLE requirement):
• Lectures prepared and presented at an accredited CLE course;
• Teaching in the specialty field at an academic institution;
• Publication of a scholarly article in the specialty field;
• Self-study review of audio or video tapes, or manuscripts of lectures from qualified CLE courses (no
more than two hours per year shall qualify).
• Advanced academic coursework (attendance at courses of instruction at a law school which can be
credited toward an advanced degree in the specialty field).
VI. Peer References
Identify as references six lawyers or judges who are familiar with your competence and qualifications in the specialty. Insofar
as possible, select persons who are board certified specialists in the specialty or substantially involved in the specialty as that
term is defined in the certification standards. Generally, all references must be licensed and in good standing to practice law in
North Carolina. However, please review your anticipated specialty’s standards for different or additional requirements regarding
peer references. You may not use as a reference persons who are your partners or associates or your relatives by blood or
marriage, or who are involved with you in a continuing commercial relationship. Applicants for recertification in bankruptcy law
may not use a bankruptcy judge as a reference. Applicants for recertification in immigration law must list at least two peer
references who are lawyers or judges with substantial experience in immigration law. Applicants for social security disability law
may list references licensed and in good standing to practice law in any jurisdiction in the United States. Members of the Board
of Legal Specialization and members of the applicable specialty committee may not serve as references. A complete list
of board and committee members is available on our website at https://www.nclawspecialists.gov/about-us/. You are
encouraged to advise your peer references (lawyers and judges) that you have listed them on this application and to confirm
that they are willing to respond to a peer reference request. Use full names (not nicknames) when listing references. Peer
reference forms will be sent to the email address you provide; please confirm with your reference that the email address you list
is correct. Upon request, hard copy peer reference forms may be sent via mail. It is the applicant’s responsibility to provide
accurate and working contact information for all peer references.
**DO NOT LIST CURRENT BOARD OR SPECIALTY COMMITTEE MEMBERS AS REFERENCES
*Prohibition applies only to specialty for which you are applying.
**Board and Specialty Committee rosters are posted on https://www.nclawspecialists.gov/about-us/.
1.
Name
Firm/Employer Mailing Address
City
State/Zip Phone
Email
8
2.
Name
Firm/Employer Mailing Address
City State/Zip Phone
Email
3.
Name
Firm/Employer Mailing Address
City
State/Zip Phone
Email
4.
Name
Firm/Employer Mailing Address
City State/Zip Phone
Email
5.
Name
Firm/Employer Mailing Address
City
State/Zip Phone
Email
6.
Name
Firm/Employer Mailing Address
City
State/Zip Phone
Email
9
ACKNOWLEDGMENT/RELEASE
I have read the rules of the North Carolina State Bar Board of Legal Specialization (the Board) and the standards
for the specialty. I agree to comply with the rules and the standards for the specialty.
Applicant’s Initials: ______
I understand that I cannot be certified as a specialist in more than two fields of law.
Applicant’s Initials: ______
I agree to pay all fees required by the Board when due.
Applicant’s Initials: ______
I understand that the period of certification is five years. If I desire to continue my certification, I must comply with
the standards regarding continued certification as a specialist.
Applicant’s Initials: ______
By this application, I release from any and all liability and extend absolute immunity to The North Carolina State
Bar, and all individuals, committees, and institutions in any way involved in this recertification process including
references and informants.
Applicant’s Initials: ______
I specifically authorize the Board or any specialty committee acting on its behalf to consult with any persons who
may have information relating to my professional qualifications, credentials or character, mental or emotional
stability, ethics, behavior, or any other matter reasonably bearing on the criteria for initial and continued
certification. This authorization includes inspecting and obtaining any writing that may be material to my
certification. I hereby authorize release of any information and writing, whether privileged or not, requested by
staff, the specialty committee, and/or the Board relevant to my application. I understand that all information
received and made part of my file shall be treated confidentially, and I expressly waive any right to request and
receive any information obtained by staff, the specialty committee, and/or the Board during the processing and
evaluation of my application.
Applicant’s Initials: ______
I hereby consent to the disclosure of any information relating to any grievance filed against me with the North
Carolina State Bar and authorize the release of any information relating thereto to the Board for the purpose of
evaluating this application for recertification. I will update the Board regarding the status of any pending grievance
until resolved.
Applicant’s Initials: ______
By executing this release, I acknowledge that I am specifically authorizing the North Carolina State Bar and the
disciplinary authorities of any other jurisdiction in which I am or was licensed to provide to the Board any and all
information concerning disciplinary complaints filed against me, even if confidential.
Applicant’s Initials: ______
I understand that board certification is a voluntary program and has no effect on my eligibility to practice law in
any area of practice even if I am denied recertification.
Applicant’s Initials: ______
I understand that the peer review process cannot serve its purpose unless the individuals from whom information
is requested are guaranteed complete confidentiality. By applying for recertification, I expressly waive any right to
request any information obtained through peer review at any stage of the recertification process.
Applicant’s Initials: ______
10
I understand that board certification, if obtained, may be suspended or revoked pursuant to the rules regulating
the specialization program of the North Carolina State Bar. I agree to report any fact or circumstance that may
trigger suspension or revocation of certification, and I agree to surrender and/or discontinue display of any
certificate of specialty certification if suspended or revoked.
Applicant’s Initials: ______
Submission of this application and its attachments constitutes the applicant’s verification of the truth of
all statements and representations contained herein.
Signature: _________________________________________________ Date: _________________
Printed Name: _______________________________________________________
11
APPLICATION CHECKLIST
(For applicant use only- do not send in this checklist with your application.)
I have read and initialed all applicable items on the Acknowledgement/Release section of the application.
I have signed and dated the Acknowledgement/Release section of the application.
I have enclosed a check for the $250.00 application fee made payable to the North Carolina State Bar Board
of Legal Specialization. I understand that this fee is nonrefundable regardless of the disposition of my
application. Applications postmarked after September 1, 2020 will be charged an additional $250.00 late
fee, for a total charge of $500.00.
I have included an application supplement form in (if applicable):
Appellate Practice
Criminal Law
Social Security Disability Law
Workers’ Compensation Law
I have submitted a Request for a Waiver of Strict Compliance Form (if applicable).
If applicable, I have requested that a letter of good standing be sent to the North Carolina State Bar Board
of Legal Specialization from any state, other than North Carolina, in which I am licensed to practice law.
I have provided a copy of any letter(s) sent to a disciplinary agency, court or professional organization
(including the North Carolina State Bar Grievance Department) requesting documentation of grievance
history and/or any information requested in Section III.
I have made a copy of this application and any attachments for my records.
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Completed 14 August 2020

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