Fillable WORKSHEET ONLY NOT FOR FINAL SUBMISSION STAT E (California)

Fill Online, Printable, Fillable, Blank WORKSHEET ONLY NOT FOR FINAL SUBMISSION STAT E (California) Form

Use Fill to complete blank online CALIFORNIA pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

WORKSHEET ONLY NOT FOR FINAL SUBMISSION STAT E (California)

On average this form takes 13 minutes to complete

The WORKSHEET ONLY NOT FOR FINAL SUBMISSION STAT E (California) form is 20 pages long and contains:

  • 1 signature
  • 0 check-boxes
  • 48 other fields

Country of origin: US
File type: PDF

BROWSE CALIFORNIA FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
STAT
E OF CALIFORNIA
OF
FICE OF THE GOVERNOR
APPLICATION FOR APPOINTMENT AS
JUDGE OF THE SUPERIOR COURT
1. Name of Applicant:
2. Prior names used by Applicant (include the dates each name was used):
3. Preferred Judicial Position (you are not required to live in the county):
Judge of the Superior Court of the State of California, County of:
4. If you would like to be considered for an appointment as a Superior Court Judge in
another jurisdiction, please identify the county or counties in order of preference and
describe your ties and connections to, and activities in, each county.
5. Date of Birth: Place of Birth:
Driver’s License Number
Social Security Number
California Bar Number
Admission Date (month/day/year)
Please indicate, by answering yes or no below, whether you meet the mandatory
eligibility requirement to serve as a judge on a California court. ("A person is ineligible to
be a judge of a court of record unless for 10 years immediately preceding selection, the
person has been a member of the State Bar or served as a judge of a court of record in
this State." (Cal. Const, Art. VI))
Yes __________________ No_____________________
If you meet the eligibility requirement for judicial service, please answer the remaining
questions set forth in this questionnaire.
INFORMATION FOR REPORTING PURPOSES
6. State law requires the Governor’s Office to collect, on an aggregate statewide basis,
demographic data relative to ethnicity, race, disability, veteran status, gender, gender
identity and sexual orientation (Gov. Code, §12011.5, subdivision (n)). To assist the
Page 1 of 14 (Rev. 3/19)
Please identify your gender: Male
Female
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
Governor’s Office with these reporting obligations, applicants are asked to voluntarily
provide the information below. YOUR ANSWERS TO THESE QUESTIONS ARE
PURELY VOLUNTARY AND YOU MAY FREELY SKIP ANY OR ALL OF THESE
QUESTIONS AND GO DIRECTLY TO QUESTION 7. If you choose to respond, use the
categories below to choose the one(s) with which you most closely identify.
□ American Indian or Alaska Native: A person having origins in any of the original
peoples of North and South America (including Central America), and who maintain
tribal affiliation or community attachment.
□ Asian: A person having origins in any of the original peoples of the Far East,
Southeast Asia, or the Indian subcontinent. The category includes, but is not limited to
people that identify themselves as Cambodian, Chinese, East Indian, Filipino,
Japanese, Korean, Malaysian, Pakistani, Thai, or Vietnamese.
□ Black or African American: A person having origins in any of the original peoples of
Sub-Saharan Africa.
□ Hispanic: A person of Cuban, Mexican, Puerto Rican, South or Central American, or
other Spanish culture or origin, regardless of race.
□ Native Hawaiian or Other Pacific Islander: A person having origins in any of the
original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
□ White or Caucasian: A person having origins in any of the original peoples ofEurope,
the Middle East, or North Africa.
□ Other: Self-identify your race or ethnicity here
Please identify your sexual orientation/gender identity:
□ Heterosexual
□ Lesbian
□ Gay
□ Bisexual
□ Transgender
Page 2 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
Please identify if you are a veteran as that term is defined in Section 101(2) of Title 38 of the
United States Code:
□ Yes
□ No
Please identify if you are person with a mental or physical disability as that term is defined in
subdivisions (j), (l), and (m) of California Government Code Section 12926:
□ Yes
□ No
PERSONAL INFORMATION
You are expected to respond fully and honestly to all requests and questions below.
Interpret the questions broadly rather than narrowly, and when in doubt, err on the
side of disclosure.
7. Provide your current residence address and county.
Street
City County State Zip
8. Provide your previous residence addresses for the past ten years, and provide
the approximate dates you resided at each.
9. Provide your preferred mailing address.
Street
City State Zip
10. Provide your current cell phone, residential telephone number and e-mail address.
Phone: ( ) Cell: ( )
Page 3 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
Home e-mail:
11. Are you a citizen of the United States? Yes No
If you are a naturalized citizen, set forth the date and place of your naturalization.
Date: Place:
12. Provide the full name, occupation and business address of your spouse, if married, or
your domestic partner, if registered, and the names and birth dates of your children, if
applicable.
13. Are you a registered voter? Yes No
a. Identify the county in which you are registered to vote. County
14. List all current and past political party affiliations, with dates of affiliation.
15. Identify your State Senator and Assembly Member
16. Identify any languages other than English that you either understand proficiently or
speak fluently.
EDUCATIONAL INFORMATION
17. Set forth your educational history, in chronological order, beginning with high school. For
each school or other institution attended, provide the name of the institution, the dates
you attended the institution, the degrees you received (if any), and the dates you
received the degrees.
Degree Date
Schools Attended From To Received Received
a. Set forth your undergraduate major.
b. Set forth any significant extracurricular activities (e.g., student groups, law review,
volunteer activities, etc.) in which you participated while in college or lawschool.
Page 4 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
PROFESSIONAL / CAREER INFORMATION
18. Set forth your professional title, and the name of your business, firm or office. Provide
your current business or professional address, and the phone number, fax number, and
e-mail address.
Professional Title
Business/Firm/Office
Street
City County State Zip
Phone: ( ) Fax: ( )
E-mail:
19. Describe with specificity the nature of your current employment.
20. If you currently practice law, identify your subject-matter areas of emphasis or
specialization, if any, including but not limited to, areas of specialization certified bythe
State Bar of California, and a description of your typical clients.
21. List the approximate month and year in which you passed the Bar exam in this state and
in any other jurisdiction in which you are admitted.
22. List all courts in which you are presently admitted to practice, including the date of
admission for each court. Provide the same information for administrative agencies that
have special admission requirements.
23. If you previously applied for a judicial appointment, specify the year(s) and the
position(s) sought. If you interviewed with the Commission on Judicial Nominees
Evaluation, please provide the approximate date of your interview.
24. Have you ever been a candidate for judicial office? If so, identify the date(s) of
candidacy, the position(s) you sought, the court(s) involved, and whether you were
elected.
25. Indicate the periods of your military service, if applicable, including the dates, the branch
in which you served, your rank or rate, your serial number, and type of discharge.
Page 5 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
26. Set forth your professional work history, including your current job, ininverse
chronological order. For each job, provide:
a. the name and address (including county) of the employer,
b. the position held,
c. a brief summary of the job duties and a description of your typical clients,
d. the name and current phone and/or or cell number, and email address of your
supervisor,
e. the dates you held the position, and
f. your reason for leaving.
QUALIFICATION / SUITABILITY FOR JUDICIAL APPOINTMENT
27. Describe your personal background, character, personality traits, professional and life
experiences, education, training, and/or skills which make you qualified and suitable for
a judicial appointment and which you believe enrich your ability to serve as a judge.
28. What role can an attorney or judge play in making our society a better place? Relate
any personal or professional efforts you have made in this regard.
29. Why do you want to be a judge? What would you seek to accomplish if appointed?
30. What professional accomplishment are you most proud of?
31. How would you describe your personality?
32. Are you able to perform, with or without reasonable accommodation, the essential
requirements of a superior court judge? These requirements include, among other
things:
Attentively receiving, analyzing and concentrating on information for a total of eight or
more hours within a work day of reasonable duration;
Perceiving a courtroom clearly, reviewing all types of evidence, including exhibits;
Reviewing and processing substantial volumes of information, originally presented in
written form (e.g., legal briefs, cases, jury instructions, transcripts);
Comprehending attorneys and others;
Absorbing, analyzing and weighing complex issues quickly and accurately; and,
Responding to situations with discretion, judgment, emotional and mental discipline,
and restraint while under pressure.
Page 6 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
SPECIFIC LEGAL EXPERIENCE
33. Describe in detail your experience, if any, in the following areas of law-related work:
a. Civil law.
b. Criminal law.
c. Juvenile, family or probate law.
d. Corporate and/or transactional law.
e. Litigation (trial and/or appellate).
f. Administrative.
g. House or staff counsel.
h. Legislative.
i. Other law-related work (specify).
34. Within the past five years, approximately what percentage of your law-related work has
been devoted to the following:
a. Litigation.
b. Administrative.
c. Legislation.
d. Alternate dispute resolution, including arbitration or mediation.
e. Teaching.
f. Other law-related work (specify).
35. In the past five years, describe how frequently you have done the following on behalf of
a client (approximate times per month, on average):
a. Appeared in federal trial and/or appellate court.
b. Appeared in state trial and/or appellate court.
Page 7 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
c. Appeared before an administrative law judge, or other tribunal.
d. Appeared before a board, commission, panel, legislative committee, or other body.
e. Participated in an alternative dispute resolution proceeding.
f. Participated in any other judicial or quasi-judicial proceeding.
36. For your entire career, state the number of cases you have tried to verdict or judgment in
federal or state trial courts.
37. For the trials identified in the preceding answer that occurred in the last five years,
provide the following additional detail (if more than five trials in the last five years, limit
your response to the five most recent trials): (1) case name, (2) case number, (3) court,
(4) trial date, (5) type and brief description of the case, (6) the party that you
represented, (7) the judge, (8) the names, current addresses and phone numbers of
counsel for the other parties, (9) the names, current addresses and telephone numbers
of co-counsel, if applicable, and (10) whether it was a jury or non jury trial.
38. For the past five years, list the five most significant matters you have resolved without
trial (e.g., by dispositive motion, settlement, negotiation). For each matter, provide the
name of the entity or tribunal involved, case name, type and description of case, dates
involved, party you represented, name of the judge or other decision maker, resolution or
disposition, names, current addresses and telephone numbers of counsel for the other
parties, and the names, current addresses and telephone numbers of co-counsel, if
applicable.
39. For your entire career, list the ten most significant matters you have handled as counsel
(which may include one or more of the matters listed in your response to the preceding
questions and may include trials, arbitrations, mediations, or cases that were resolved
before trial). For each matter, provide the name of the entity or tribunal involved, case
name, type and description of case, dates involved, party you represented, name of the
judge or other decision maker, resolution or disposition, names, current addresses and
telephone numbers of counsel for the other parties, and the names, current addresses
and telephone numbers of co-counsel, if applicable. In a sentence or two, please
explain why you believe each case is significant.
40. Provide legal citations to all reported cases or decisions identifying you as a counsel of
record.
41. For your entire career, estimate the number of depositions you have either taken or
defended.
42. For your entire career, estimate the number of oral arguments you have conducted
related to a dispositive motion.
Page 8 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
43. To the extent not listed above, provide one or two examples of the most significant law-
related activities on which you have worked in the last five years that did not involve an
actual “case or controversy” (e.g., policy work, legal research and/or writing, committee
or task-force work, public speaking, mentoring, a corporate transaction, bar activities,
etc.).
44. If you have taught at a college, university or law school, identify the school and the dates
that you taught, and describe the nature of your appointment and the course(s) you
taught.
JUDICIAL OR QUASI-JUDICIAL EXPERIENCE
45. Are you currently serving as a judicial officer or quasi-judicial officer:
a. Identify your judicial or quasi-judicial position:
i. Were you appointed? Yes No
Date of appointment:
ii. Were you elected? Yes No
Date of your election:
46. If you have served as a judicial officer, or quasi-judicial officer, provide the
following information:
a. The dates you served as a judicial or quasi-judicial officer.
b. Your duties.
c. List ten significant cases in which you presided as the judicial officer or quasi-judicial
officer. For each case, provide the case name and number, a brief description of the
case, the dates involved, and the names, current addresses and telephone numbers
of counsel for the parties. Furnish a copy of any opinions, orders or decisions that
you rendered in those cases that included substantial discussion of legal issues.
Written materials submitted in response to this question must not exceed a total of
25 pages.
47. Describe the nature and extent of your service, if any, as a judge pro tem, arbitrator,
mediator or neutral. Describe the more significant cases and identify the counsel
involved, including names, current addresses and phone numbers, and dates of your
service.
BUSINESS INTERESTS OR OTHER PROFESSIONAL EXPERIENCE
Page 9 of 14 (Rev. 3/19)
WRITING
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
48. If you are now an owner, officer, director, manager or supervisor of any business
enterprise (whether for-profit or non-profit), identify the name of the enterprise, nature of
the business, title of your position, nature of your duties, term of your service, and
whether you intend to resign the position immediately upon your appointment to judicial
office. If you do not intend to resign, please provide the reasons.
49. During the past five years, have you received any fees or compensation of any kind,
other than for legal services rendered, from any business enterprise, institution,
organization or association? If so, identify the source of the compensation, nature of the
business enterprise, institution, organization or association, dates the compensation was
paid, and the nature of any services rendered by you.
50. Have you ever held public office other than a judicial office, or have you ever been a
candidate for such an office? If so, provide the details, including the office(s) involved,
whether you were elected or appointed, the county and state in which you held office,
and the dates of your service.
51. Have you ever held or applied for a commission, certificate, credential or license which
required proof of good character, other than admission to practice law? If so, identify the
date(s) of application, the issuing authority, the disposition of any such application, and,
if granted, your number and present status.
52. Describe your significant legal writing. In addition, if you have written, edited or
published any legal or non-legal books, articles, letters to the editor or reports, please list
them, giving full citations, dates, and a general description of the subject matter. Please
attach a copy of any letters to the editor or op-ed articles you have authored. Letters to
the editor and/or op-ed articles submitted in response to this question must not exceed a
total of 25 pages.
HONORS AND AWARDS
53. List any honors, prizes, awards, scholarships, fellowships or other forms of recognition
with dates you have received.
ORGANIZATIONS, MEMBERSHIPS
AND COMMUNITY
ACTIVITIES
54. List all bar associations, committees, and legal professional societies in which you are,
or have been, a member. In addition, give the titles and dates of any offices you held or
subcommittees on which you served.
55. List all organizations, boards, clubs, associations or other groups (other than the bar
associations and professional societies identified above) in which you have been a
member. Regarding those organizations, identify the titles and dates of any offices you
have held or committees on which you served.
Page 10 of 14 (Rev. 3/19)
ADDITIONAL QUESTIONS
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
56. Are you a member of any club, organization, association or group that by policy or
practice prohibits or limits its membership on the basis of race, color, religion, sexual
orientation, gender, disability or national origin? Have you ever been? If so, identify the
organization and provide details.
57. Describe the nature and extent of any free legal services you have provided to non-profit
organizations, indigent individuals or others, including the names and addresses of the
organizations and/or individuals and dates of service.
58. Describe the nature and extent of your involvement in community activities or
community affairs other than those associated with the legal profession.
59. Describe your hobbies and/or personal interests.
60. Have you ever been:
a. Summoned, cited, arrested, taken into custody, indicted, convicted or tried for, or
charged with, or pleaded guilty or no contest to, the violation of any felony,
misdemeanor, or infraction violation (excluding traffic infractions)?
b. Ordered to appear before any prosecuting attorney, investigative agency, or
administrative tribunal, in any matter, military or civil?
c. Ordered to appear as a party to any grand jury investigation in which you were
identified as a subject, or in which you appeared as a witness. If so, provide the
details, including the date, description of the alleged offense, locality and disposition.
61. Have you ever been a party to, or claimed an interest in, any civil proceedings (including
dissolution of marriage, bankruptcy, damage suits, etc.)? Include all legal proceedings in
which you were a party in interest, a material witness, or named as a co-conspirator or
co-respondent. Do not list proceedings in which you were merely a guardian ad litem or
stakeholder. Provide the names, current addresses and telephone numbers of counsel
for the parties in each case.
62. As an attorney or judicial officer, have you ever been:
a. Disciplined or cited for a breach of ethics or unprofessional conduct by, or been the
subject of a complaint to, any court, administrative agency, bar association,
disciplinary committee or other professional group?
b. Sanctioned in excess of $1,000 by any court or for contempt in any court or tribunal
having the power of contempt? If so, give the details, including the relevant dates
and the names, current addresses and telephone numbers of the judges involved
Page 11 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
and the counsel for the adverse parties. (Identify every complaint even if it was
dismissed, did not result in disciplinary action or a finding of contempt.)
63. Have you ever been charged in any civil, criminal or administrative action with conduct
alleged to involve moral turpitude, dishonesty and/or unethical conduct? If so, provide
the particulars, including the applicable dates and the names, current addresses and
telephone numbers of the counsel for the adverse parties.
64. As a member of any organization, or as a holder of any office or license (including a
driver’s license), have you ever:
a. Been suspended, or otherwise disqualified, or had such license suspended or
revoked?
b. Been reprimanded, censured or otherwise disciplined?
c. Had any charges, formal or informal, been made or filed against you? If so, state the
complete facts and identify the dates, the disposition, and the organization in
possession of the relevant records.
65. Have you ever held a bonded position? If so, specify the nature of the position(s), the
date(s), and the amount of bond.
a. Has anyone ever sought to recover upon your bond or to cancel your bond? If yes,
provide the details.
b. Have you ever been refused bond? If yes, provide the details.
66. Have you ever been sued by a client? If so, provide the particulars, including the case
name and number, court, resolution, and name, current address and telephonenumber
of counsel for the plaintiff.
67. Have you or your professional liability insurance carrier ever settled a claim against you
for professional malpractice? If so, provide the particulars, including the amounts
involved and the name, current address and telephone number of the claimant and
claimant’s counsel.
68. Are there any unsatisfied judgments against you, or are you in default in any way in the
performance or discharge of any duty or obligation imposed upon you by decree or order
of any court (including any orders for child and spousal support)? If so, state the full details.
69. Has a tax lien or other collection procedure ever been instituted against you by federal,
state or local authorities? If so, provide the particulars, including the amount at issue,
the applicable dates, and the status of the matter.
70. Have you always filed appropriate tax returns as required by federal, state, local and
other government agencies? If not, provide an explanation, including the amount at
Page 12 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
issue, date and resolution.
71. If any articles or allegations have ever been printed or broadcast or otherwise made
public concerning you or your activities, views or statements (irrespective of factual
accuracy) which may reflect adversely on your character or job performance, identify the
material, explain fully the nature of the assertions involved, and attach a copy of each
publication to this application. (If the volume is extensive, attach representative samples
of the publications and, if not self- identifying, provide the title, publication, broadcast date
and or google description where articles or broadcast can be viewed.) Written materials
submitted in response to this question must not exceed a total of 25 pages.
72. Are you aware of any individual(s) or group(s) who might oppose your appointment? If
so, identify the potential opponents and provide any needed explanation.
73. Describe any aspects of your personal, business, educational, professional conduct or
background, which might reflect adversely on you or the Governor or might embarrass
you or the Governor or which you believe should be disclosed to the Governor in
connection with your application for appointment to judicial office.
FURTHER INFORMATION
74. Please list five references (name, current address, telephone and/or cell number, email
address, and a short one- sentence description of your relationship to the reference).
NOTE:
In addition to submitting your electronic application, in order to be considered for
appointment by Governor Newsom, you must scan and email the following
materials to judappts@GOV.CA.GOV
a) Your photograph and a current resume,
b) All written materials submitted in response to any of the above questions. Your
submission must identify the specific question to which your written materials
correspond,
c) Your signed authorization, certification and release form.
Page 13 of 14 (Rev. 3/19)
WORKSHEET ONLY – NOT FOR FINAL SUBMISSION
CERTIFICATION, AUTHORIZATION AND RELEASE
I hereby acknowledge and agree that my application may be given to the Commission on
Judicial Nominees Evaluation of the State Bar of California (“JNE Commission”) in the event
my name is submitted for evaluation by that agency; and that all or portions of my application
or the information contained therein may be given to or shared with the judicial evaluation
committee of my local bar association (if that association is providing such assistance to the
Governor’s Office) and other committees and/or individuals who have been asked by the
Governor to assist him in the evaluation of applicants for judicial appointment. I further
acknowledge and agree that for the purpose of aiding the Governor in evaluating my
background and qualifications, the foregoing organizations and individuals will be entitled to
seek and obtain information and documents concerning me from firms, companies,
corporations, law schools and other educational institutions, attorneys, judges and other third
parties, including those mentioned in my application.
I hereby authorize any governmental, licensing or law enforcement agency, including but not
limited to the State Bar of California and the Commission on Judicial Performance, and major
national credit reporting organizations (collectively referred to as “agencies”) to release to the
Governor of the State of California and to the JNE Commission any and all information which
those agencies may have about me (whether public, personal or confidential) for the purpose
of aiding the Governor in evaluating my background and qualifications for appointment to the
trial or appellate court. I understand that I will not receive and am not entitled to know the
contents of confidential reports received from these agencies and I further understand that
these reports are privileged, except that I am entitled to receive a copy of reports from major
national credit reporting agencies and the Commission on Judicial Performance.
I hereby release and discharge the Governor and his representatives, the JNE Commission,
all agencies, their agents and representatives, and any person furnishing information from any
and all liability of every nature and kind arising out of the furnishing, use and inspection of
documents, records and other information and the investigation of my background and
qualifications, and this release shall be binding on my legal representatives, heirs and
assignees.
I hereby declare under penalty of perjury under the laws of the State of California that
the answers and statements provided by me in the forgoing application are true and
correct.
Type or Signature Print
Name
Executed at on ,
Page 14 of 14 (Rev. 3/19)
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

WORKSHEET ONLY NOT FOR FINAL SUBMISSION STAT E (California)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 12 January 2022

Message

View Audit Log
Print With Audit Log
Duplicate Document