N.Y. Comp. Codes R. & Regs. tit. 22 § 691.11 : JUDICIARY — Courts — Supreme Court — Second Judicial Department — Appellate Division — Special Rules — Conduct Of Attorneys — Reinstatement following suspension, disbarment, or striking of name from roll of attorneys

________, being duly sworn, deposes and says (or affirms under the penalty of perjury) that:

1. I hereby apply, pursuant to Judiciary Law § 90 and 22 NYCRR 691.11, for reinstatement as an attorney and counselor-at-law licensed to practice in all of the courts of that State of New York.

2. My full name is ________. The name under which I was admitted to the practice of law is ________. My name was changed on the Roll of Attorneys and Counselors-at-Law to ________ by reason of (marriage, divorce or annulment, or a court order legally changing the movant's name). I have also been known by the following names:

3. I was born on (date) in (city, state, country).

4. I currently reside at (street, town or city, state, and zip code).

5. The telephone numbers at which I can be contacted are:

Home ________

Work ________

Mobile ________.

6. The e-mail address at which I can be contacted is ________.

7. I was admitted to the New York State Bar on (date) in the ________ Judicial Department.

8. By opinion and order of this court dated (date), I was (suspended for ________ years/disbarred) from the practice of law. My use of the term "discipline" hereinafter refers to the sanction imposed by this court in the foregoing opinion and order.

A copy of the opinion and order imposing discipline is attached as exhibit A hereto.

9. Other than the location specified in paragraph 4 hereof, I have resided at the following addresses since the effective date of discipline (in reverse chronological order state the approximate dates of residence, street, town or city, state, and zip code):

10. The discipline imposed upon me was predicated upon, or arose out of, my misappropriation or misuse of the real or personal property of others, or the failure to return legal fees received but unearned by me. I have made full restitution to the owners of the property or the clients in question, and if any part of a loss occasioned by my conduct was the subject of an award by the Lawyers' Fund for Client Protection pursuant to 22 NYCRR Part 7200, I have made full restitution to the Fund, except as follows:

A statement listing each property, its dollar value, the name of the true owner, and the extent to which I have made or have yet to make restitution is attached as exhibit ________ hereto.

11. I have also been admitted to practice in the following jurisdiction:

Certificates of Good Standing, issued within the 30 days preceding the execution of this affidavit (or affirmation) by all such jurisdictions, except those in which I have not been reinstated as set forth in paragraph 12 hereof, are attached as exhibit ________ hereto.

12. Since the imposition of discipline, I have also been the subject of professional discipline in the following other jurisdictions (state the jurisdiction, the date, the nature of the discipline imposed, and whether or not you have been reinstated to practice and are now good standing in such jurisdiction):

A copy of each order or judgment imposing such discipline is attached as exhibit ________ hereto. A copy of each order or judgment reinstating me to practice is attached as exhibit ________ hereto.

13. On the effective date of discipline, the following matters, which were not the basis of this court's opinion and order, were pending against me before any grievance committee in the State of New York (state the nature of the complaint, the disciplinary authority before which it was pending, and the disposition thereof):

14. From the date of my admission to the New York State Bar until the present, the following other disciplinary sanctions have been imposed upon me due to my misconduct as an attorney, in this or any other jurisdiction (state the jurisdiction, the nature of the misconduct, the date, and the nature of the discipline imposed):

15. Since the imposition of discipline, I have engaged in the practice of law in the following other jurisdictions and in the following manner:

16. Since the imposition of discipline, I have engaged in the following employment or have been engaged in the following businesses (in ascending chronological order, state the dates so engaged, and the name and address of the employer or business):

A letter from each such employer, attesting to my employment history, is attached as exhibit ________ hereto, except ________, the absence of which is explained as follows:

17. At the time discipline was imposed, I took the following affirmative steps to comply with the order imposing discipline and with 22 NYCRR 691.10:

18. Pursuant to 22 NYCRR 691.10(f), I filed an affidavit of compliance on (date).

A copy of that affidavit of compliance is attached as exhibit ________ hereto.

- or -

I failed to file an affidavit of compliance as required by 22 NYCRR 691.10(f) for the following reasons(s).

19. Since the imposition of discipline, I or a corporation or an entity of which I am or was a principal, have or has been involved in the following lawsuits, either as a party, witness, or counsel to a party, to the extent indicated (state the title of the suit, the court in which it is or was pending, the index number, the nature of the suit, and the capacity [plaintiff, defendant, counsel, etc.] in which the movant is or was involved):

20. There presently exist(s) the following unsatisfied judgment(s) against me and/or any corporation or entity of which I am or was a principal (state the name and address of the judgment creditor, the court which rendered the judgment, the date and amount of the judgment, the nature of the claim on which it was based, and the amount thereof remaining unpaid):

21. Since the imposition of discipline, I have defaulted in the performance or discharge of an obligation or duty imposed upon my by the following courts, and/or governmental or administrative agencies (state the nature of the obligation or duty, the court or agency by which it was imposed, the date performance was due, and the reason for the default).

22. Other than the judgments set forth in paragraph 20 hereof, I have incurred the following debts with a balance over $500 that are presently overdue by at least 60 days (state the name and address of each creditor, the nature of the debt, the original amount of the indebtedness and date incurred, the due date, and the balance due):

23. I or any firm, corporation, or business entity in which I have or had an ownership interest filed a petition in bankruptcy on (date) to (court).

Copies of any bankruptcy petitions, schedules, and or discharge orders are attached as exhibit ________ hereto.

24. Since the imposition of discipline, I have filed all required Federal, state, and local income tax returns when due or have received an extension to file the same, except as follows:

Copies of all such returns are attached as exhibit ________ hereto.

25. Since the imposition of discipline, I have applied for the following licenses that required proof of good character (state the nature of the license, the name of the licensing authority, the date of the application, and the result thereof):

26. Since may admission to the New York State Bar, I have had the following licenses suspended or revoked (state the nature of the license, the name of the licensing authority, the date and reason for the action, and whether the license was revoked or suspended):

27. Since the imposition of discipline, I have been arrested, charged with, indicated, convicted, tried, and/or entered a plea of guilty to the following felonies, misdemeanors, violations, and/or traffic infractions (state the court, the offense charged, and date and nature of disposition):

28. Since my admission to the Bar, I have been the subject of the following governmental investigation(s) (state the name of the investigating agency and the nature and date of the investigation):

29. Since the imposition of discipline, I have suffered from or have been treated for a mental or emotional disorder, alcoholism and/or substance abuse or dependency (state the date or dates of each instance, the name of any health professional or institution consulted or affording treatment, and the circumstances):

30. Since the imposition of discipline, I have complied with the requirements of 22 NYCRR 691.11(c)(2) by attaining a passing score on the Multistate Professional Responsibility Examination (MPRE) and, within the two years preceding this application for reinstatement, successfully completing one credit hour of continuing legal education (CLE) accredited in accordance with 22 NYCRR Part 1500 for each month of suspension or disbarment up to a maximum of 24 credits.

Proof of passage of the MPRE and certificates attesting to my completion of the required CLE are attached as exhibit ________ hereto.

-or-

Since the imposition of discipline, I have complied with the requirements of 22 NYCRR 691.11(c)(2) to the extent of attaining a passing score on the Multistate Professional Responsibility Examination (MPRE). However I have not complied with the requirement that, within the two years preceding this application for reinstatement, I successfully complete 24 credit hours of continuing legal education (CLE) accredited in accordance with 22 NYCRR Part 1500. For the following reasons, I hereby request that the court conditionally approve this application subject to the completion of the CLE requirement before reinstatement to the bar:

Proof of passage of the MPRE is attached as exhibit ________ hereto.

31. Within the 30 days preceding the execution of this affidavit (affirmation), I have read the Rules of Professional Conduct rules set forth in 22 NYCRR Part 1200 of the joint rules of the Appellate Divisions and I have read 22 NYCRR Part 691 of the rules of this court. I am familiar with the provisions of the Rules of Professional Conduct. If reinstated to the practice of law, I will conform my conduct to those rules.

32. Other than the passage of time and the absence of additional acts of misconduct, the following facts establish that I possess the requisite character and general fitness to be reinstated as an attorney and counselor-at-law:

33. The following facts, not heretofore disclosed to this court, are relevant to this application and might tend to influence the court to look less favorably upon reinstating me to the practice of law:

34. I understand that the court may take such investigative steps as it deems appropriate to evaluate my character and fitness for reinstatement to the Bar. I will fully cooperate with any request for additional information and make myself available to answer questions under oath or affirmation, as required.

WHEREFORE, I request that the court grant this application for my reinstatement as an attorney and counselor-at-law licensed to practice in all of the courts of the State of New York.

Dated: (city or town, state)

________ ________, 200________

________

Subscribed to and sworn to before me this ________ day of ________, 200________

________

Notary Public

2. My full name is ________. The name under which I was admitted to the practice of law is ________. bdelMy name was changed on the Roll of Attorneys and Counselors at Law to by reason of (marriage, divorce or annulment, or a court order legally changing the movant's name).edel I have also been known by the following names: