IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
    				                 
APPLICATION FOR READMISSION OR REINSTATEMENT TO THE BAR OF THE COURT
PURSUANT TO D.C.COLO.LCivR 83.5.I OR D.C.COLO.LCrR 57.7.I

Pursuant to D.C.COLO. LCivR 83.3 and D.C.COLO. LCrR 57.5, admission to the bar of this court is limited to those who are in good standing in all courts and jurisdictions where admitted.  Pursuant to D.C.COLO. LCivR 83.5.I and D.C.COLO. LCrR 57.7.I an attorney who is not in good standing due to suspension or disbarment may apply for reinstatement or readmission utilizing the following form.  

 1, Name on File 			(M		)		(F		)	

2. Other Names Used:		

3. Firm Name:		

4. Firm Address:									
   
    City:				
State:			
Zip:		

 5. Office Telephone:	(        )			Office Fax:	(        )		

6. Email Address:		

7. Date First Admitted to This Court:		
 
 8. Colorado Bar Number (if applicable)     ___________________________________________________________

9. Date Suspended or Disbarred by This Court		

10. Give full explanation of the discipline that led to the suspension or disbarment in this court as noted in Item No. 9.  Include the disciplining jurisdiction, date of discipline, type of discipline and conduct that led to discipline.  Use a separate sheet if necessary.  Attach documentation.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________	

11. Were you disciplined by any jurisdiction other than this court and was that discipline that which led to suspension or disbarment in this court?   Yes________     No________  If yes, give full explanation, including the name, address and telephone number of each disciplining jurisdiction(s), the date and type of discipline, and your current standing in each jurisdiction that disciplined you (e.g., reinstated with or without conditions; still under suspension or disbarment, etc.).  Use separate sheet if necessary.  Attach documentation.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________	

12. Other than the discipline (if any) described in Item No. 11, have you received any discipline (including disbarment, suspension, censure or reprimand) in any jurisdiction since you were suspended or disbarred by this court?     Yes ___________     No___________  If yes, indicate the jurisdiction (including address and telephone), date and nature of the discipline, and reason for the discipline.  Use a separate sheet if necessary.  Attach documentation.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________	

13. Pursuant to D.C.COLO.LCivR 83.5.I and D.C.COLO.LCrR 57.7.I, reinstatement or readmission is neither automatic nor a matter of right.  Explain why the court should grant your application for reinstatement or readmission.  Use a separate sheet if necessary.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________	

14. I consent to this court's exercise of disciplinary jurisdiction over me in connection with this application and any alleged misconduct related to my admission to and practice before the bar of this court.	

15. I certify that I have read and am familiar with the local rules of this court and that I will comply with all of the provisions thereof.	

16. I recognize that, if readmitted to the bar of this court, I am duty bound to give immediate written notice to the clerk of the court of any formal discipline imposed upon me, including dates and terms thereof, by any court or attorney licensing agency.	

17. I solemnly swear (or affirm) that as an attorney and counselor of this court, I will conduct myself in a professional and ethical manner at all times, and I will support and defend the Constitution of the United States.	

	Signature	

Subscribed and sworn to before me this		day of		,		

My Commission Expires:			

	Notary Public 	

                                    Submit original and one copy to:	Gregory C. Langham, Clerk
Attn: Secretary for Committee on Conduct
United States District Court
Alfred A. Arraj U.S. Courthouse, Room A-105
901 19th Street
Denver, Colorado 80294-3589
Phone (303) 844-3433