ATTORNEY QUESTIONNAIRE DATE: NAME: ADDRESS: PHONE: 1. List each college and law school you attended, including the dates of attendance, the degree awarded, and your reason for leaving each school if no degree from that institution was awarded. 2. List all Jurisdictions in which you are presently admitted to practice, including the dates of admission in each case. 3. Indicate the periods of your military service, including the dates, and the branch in which you served, your rank or rate, and the kind of discharge received. 4. Are you actively engaged in the practice of law at the present time? If you are connected with a law firm, a corporate law department, or a governmental agency, please state its name and indicate the nature and duration of your relationship. If "not applicable" enter a check mark on this line __________ 5. What is the general character of your present practice and mention any legal specialties which you possess. (If needed, use additional sheet of paper and attach to questionnaire.) 6. Do you regularly appear in Court? Yes ____ No _____ 7. What percentage of your appearances are: a. Federal Courts: ________ % b. State Courts: _________ % c. Other Forums: ________ % 8. What percentage of your litigation is: a. Civil: _________% b. Criminal: ________% 9. Approximately how many criminal cases have you handled as counsel of record? 10. State the number of jury cases you have tried to verdict and court trials to judgment during your career, indicating whether you were sole, associate or chief counsel. 11. Describe some of the more significant litigated matters which you have handled and give the citations if the cases were reported. (If needed use plain sheets of paper to answer and attach to questionnaire.) 12. Have you ever been engaged in any occupation, business or profession other than the practice of law? If so, give details and dates. No _________ Yes _________ 13. Have you ever held public office, or have you ever been a candidate for such office? If so, give the details, dates, offices involved, whether elected or appointed, and the length of your service. No _________ Yes __________ 14. (A) Have you ever been convicted for violating any Federal law, State law, County or Municipal law, regulation or ordinance? Do not include traffic violations other than drunk driving, evading responsibility, reckless driving, negligent homicide, misconduct with a motor vehicle, or driving after suspension. No ________ Yes _______ (B) Are there any such charges pending? No _______ Yes _________ (If the answer to A) or B) is yes, please give details on a separate sheet of paper. 15. Have you ever been sued by a client? No _________Yes ________ (Do not include Habeas Corpus petitions alleging IAC). 16. Have you ever had a finding of IAC made against you in a Habeas Corpus proceeding? (If so, give particulars on an additional sheet of paper and attach.) 17. Have you ever been a party in any other legal proceedings other than dissolution of marriage? No ________ Yes ___________ (If so, give particulars on an additional sheet of paper and attach.) 18. Have you ever been disciplined or cited for a breach of ethics or unprofessional conduct by any Court, Administrative Agency, Bar Association, Disciplinary Committee, or other professional group? No _______ Yes __________ (If so, give particulars on additional sheet of paper and attach.) 19. Are you currently addicted to drugs or are you currently impaired by alcohol abuse? No _______ Yes __________ 20. Have you published any legal books or articles? No _______ Yes _________ If so, list them, giving the citations and dates. 21. List all Bar Associations and professional organizations of which you are a member and give the titles and dates of any offices which you have held in such groups. 22. List any professional activities that you have participated in on a voluntary or appointed basis. 23. List any significant criminal practice and trial advocacy training programs or seminars that you have attended. 24. State all civic, charitable or social organizations with which you have been connected, and the facts concerning such connection, for the past five years. 25. List any honors, prizes, awards or other forms of recognition which you have received. 26. Names of six lawyers and/or judges who know you and your work and who can be interviewed relative to your qualifications as a lawyer. Please include addresses and telephone numbers.