F O R M M 14
Con n ecticut Bar Exam in in g Com m ittee
10 0 Washin gton Street H artford, CT 0 610 6 -4411
AFFID AVIT OF ATTOR N EY AD M ITTED
FOR AT LEAS T FIVE YEAR S
IN RE TH E APPLICATION OF
FOR ADMISSION TO TH E CONNECTICUT BAR WITH OUT EXAMINATION.
1. Affian t's Nam e
2. Affian t's addr ess an d teleph on e n um ber (in dicate wh eth er h om e or busin ess):
Firm :
Street:
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State |
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Ph on e: H |
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3a. J urisdiction in wh ich you ar e adm itted to th e bar: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3b. Date of adm ission to th e bar listed in # 3a above: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
4 . H ow lon g h ave you kn own th e applican t? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
5. Are you related to th e applican t? _ _ _ _ _ _ _ If so, in wh at way? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
6 . Wh at opportun ities h ave you h ad to form an opin ion of th e applican t's profession al an d person al ch aracter an d fitn ess to practice law in Con n ecticut? Be specific.
7. Would you recom m en d th e applican t for a position of trust? _ _ _ _ _ _ If n ot, please tell us wh y.
8 . In your opin ion , does th e applican t possess th e ch aracter an d fitn ess to practice law in Con n ecticut? _ _ _ _ _ _ _ _ _ _ _ If n ot, please tell us wh y.
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F O R M M 14 |
9 . To your kn owledge h as th e applican t ever been : |
YES |
NO |
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Arrested or con victed of a crim e |
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Accused of a violation of trust |
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Dr opped, suspen ded from , disciplin ed or placed on probation by an education al |
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in stitution |
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A party to a law suit (in cludin g ban kruptcy) |
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Treated for th e use of drugs, n ar cotics or alcoh ol |
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Den ied adm ission to th e bar of an y jurisdiction |
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Delin quen t in an y fin an cial obligation |
10 . To your kn owledge is th e applican t curren tly sufferin g from a disability wh ich would im pair th e applican t's ability to practice law? _ _ _ _ _ _ _ _ _ _ _ _ If so, explain .
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If you an swered "yes" to an y of th ese question s, please tell us about it . You m ay also use th is space for an y addition al com m en ts you wish to m ake about th e applican t .
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11.Wh at opportun ities h ave you h ad to kn ow th e n atur e an d duration of th e applican t's practice of law?
12. H as th e applican t been lawfully en gaged in th e practice of law as h is/ h er prin cipal m ean s of livelih ood for at least five of th e last ten years? Please describe th at pr actice.
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(Sign atur e)
Sworn to before m e th is _ _ _ _ _ _ _ _ _ _
day of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , 20 _ _ _ .
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(Notary Public)
