Free Motion for Admission Pro Hac Vice - District Court of Arizona - Arizona

UNITED STATES DISTRICT COURT ——- HLED no LODGE
FOR THE DISTRICT OF ARIZONA __ RECEIVED __Jy_ COPY
Association of American ‘
Physicians and Surgeons, etal., ) 0 4 ,
PlaInt1i`f(s)‘/PetIt1oner(s), ) CLERK U 5 D!S_mJCT COURT l
) CASE NO3 CV04·0200 PHX ENC oisrsicr or xiaamrla
vs, ) BY-—~———-—--.-..-...,..., DIEPLJTY
Jan Brewer, at éI_ Q ) Application of Attorney For Admission To Practice
) Pro Hac Vice Pursuant to LRCiv 83.1(b)(3)
Defendant;s)/Respondentts) )
NOTICE: Please submit the $lUll fee with your application.
I, James SamPl9 , hereby applyto the Court under LRCiv 83.1(b)(3) for pro hac vice
admiggign tg) appear and prggtigg in this action on behalf of IFIIBNEFIDFS-Deféhdanls SIBVBI1 S. POS and Clean El€CllOl‘lS ll"ISlllUlG, IDC. ,
CITY AND STATE OF PRINCIPAL RESIDENCE: New York, NY
IFIRM NAME: Brennan Center for Justice at NYU School of Law
ADDRES5; 161 Avenue of the Americas, 12th Fl. » I SUITE;
I cirv; New Y¤tl< STATE: NY ZIP: 10013
FIRM/BUSINESS PHONE: ( 212 ) 998-6730
FIRM FAX rrroisirzz (212 ) sssagso E-MAIL ADDRESS: lame-$¤m¤'¤@¤¥¤-edu
I am admitted to practice before the following courts. (attach additional sheets if necessary)
TITLE OF COURT DATE OF ADMISSION IN GOOD STANDING
(circle)
See attached sheet. Yes I Noe
Yes f No*
· - Yes f -No*
(An Original Certiticate of Good Standing from a FEDERAL BAR in which an applicant has been admitted dated no more than 45 days prior to
submission of this appiication is required.)
I have concurrently, or within I year of this application, made pro hoc vice applications to this Court in the following actions (attach
additional sheets if necessary):
CASE NUMBER TITLE OF ACTION DATE GRANTED OR DENIED*
*EXPLAIN:
ALL APPLICANTS ARE REQUIRED T0 ANSWER THE FOLLOWING QUESTIONS.
If you answer YES to either of the following questions, please explain all circumstances on a separate page.
Are you currently the subject of a disciplinary investigation or proceeding by any Bar or Court'? Y!
Have you ever been disbarred from practice in any Court? Y
I declare under penalty of perjury that the foregoing is true and correct; that I am not a resident of, nor am I regularly employed,
engaged in business, professional or other activities in the State of Arizona; and that I am not currently suspended, disbarred or
subject to disciplinary proceedings in any court. I have read and will ascribe to the Standards for Professional Conduct, and will
comply with LRCiv 83.1(c). ‘
gala Q.,
D e @ licant `
__ _____ _$ _____ (Rev. moe)
Case 2: -cv-00200-EHC Document 66 Filed O1/O4/2008 Page 1 of 3

_ Court Admissions of James J. Sample
Title of Court Date of Admission In Good Standing?
U.S.C.A. for the 2nd Circuit 03/05/2007 Yes
Courts ofthe State of Montana 02/ 14/2007 Yes
_ U.S.D.C. for the Eastern District of New York 03/03/2006 Yes
Courts of the State of New York 11/09/2004 Yes
Application of Attorney James J. Sample for Admission Pro Hac Vice in Association of American Physicians and
Surgeons, et al. v. Brewer, et al., Case No. CV—04—O200 PXH EHC
Case 2:04-cv-00200-EHC Document 66 Filed O1/O4/2008 Page 2 of 3

¤ AO 136 (Rev. 9l98) Certificate of Good Standing
UNITED STATES DISTRICT COURT
Eastern DISTRICT OF New York
CERTIFICATE OF
GOOD STANDING
L _m_ Robert C. Heinemann __, Clerk of this Court,
GQVFU? that Jams J- Sample ·B“’“ it ;i?;i;i;iT?itT;; I
was duly admitted to practice in this Court on
, §i@ YV,V7,_w,Y__ ,__ ____ and is in good standing
DATE
as a member ofthe Bar of this Court.
Dated at_ Brooklyn, N.Y. T____ on ___December 21, 20(Q .
____ M __ w ___ H LOCATJGN _ DATE
W__iRg_bert C. Heinemann l l L ,,Marc
CLERK E; DEP T Y CLERK Administrative Supervisor
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