U.S. District Court for the Northern District Of Illinois
Attorney Appearance Form
Case Title:
Case Number:
An appearance is hereby filed by the undersigned as attorney for:
Attorney name (type or print):
Firm:
Street address:
City/State/Zip:
Bar ID Number:
Telephone Number:
Yes No
Yes No
Yes No
Yes No
(See item 3 in instructions)
Email Address:
Are you acting as lead counsel in this case?
Are you acting as local counsel in this case?
Are you a member of the court’s trial bar?
If this case reaches trial, will you act as the trial attorney?
If this is a criminal cas
e, check your status.
Retained Counsel
Appointed Counsel
If appointed counsel, are you
a
Federal Defender
CJA Panel Attorney
______________________________________________________________________
In order to appear before this Court an attorney must either be a member in good standing of this Court’s
general bar or be granted leave to appear pro hac vice as provided for by local rules 83.12 through 83.14.
I declare under penalty of perjury that the foregoing is true and correct. Under 28 U.S.C.§1746, this
statement under perjury has the same force and effect as a sworn statement made under oath.
Executed on
Attorney signature: S/
(Use electronic signature if the appearance form is filed electronically.)
Revised 8/1/2015