APPLICATION FOR APPOINTMENT AS COUNSEL PURSUANT
TO ARTICLE 11.071, CODE OF CRIMINAL PROCEDURE
DATE: _________________________
STATE BAR CARD NO.: _____________________________
I. GENERAL INFORMATION
Full Legal Name: _________________________________________________________
Office Address: __________________________________________________________
Suite/Building/Number/Street
_________________________________ AC( )______________________________
City/State/Zip
Office Telephone
**Mailing Address (if different): _____________________________________________
Home Address: ___________________________________________________________
Number/Street
____________________________________ AC(
)___________________________
City/State/Zip
Home Telephone
Email Address: ___________________________________________________________
Date of Birth:_____________ Social Security
Number____________________________
II. PEER REVIEW
I submit the following 5 lawyers and judges, not partners or associates of
mine, who may be contacted and who can attest to my competence in criminal law.
A. Three lawyers who practice in my geographical area and are familiar with my
practice:
1. _____________________________________ AC( )________________________
Name Office
Telephone
____________________________________________________________________
Address
City/State/Zip
2. _____________________________________ AC( )_________________________
Name Office
Telephone
________________________________________________________________________
Address
City/State/Zip
3. _____________________________________ AC( )__________________________
Name Office
Telephone
________________________________________________________________________
Address
City/State/Zip
B. One judge of a court of record in Texas before whom I have appeared as an
advocate in a criminal law matter within the two (2) years immediately
preceding this application:
4. ______________________________________________________________________
Name of Judge
________________________________________ AC ( )________________________
Name of Court
Office Telephone
_______________________________________________________________________
Address
City/State/Zip
C. One Texas lawyer with whom or against whom I have tried a criminal law
matter within the two (2) years immediately preceding this application:
5. ______________________________________ AC( )_______________________
Name
Office Telephone
_______________________________________________________________________
Address
City/State/Zip
D. The following is a representative list of the judges before whom I have
appeared in criminal law matters during the two (2) years immediately preceding
this application:
STATE DISTRICT COURTS
Name
Court
County Office
Telephone
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
STATE
APPELLATE COURTS
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
FEDERAL COURTS
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
OTHER COURTS
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
____________________ __________________ ___________ (___)________________
III. EDUCATION/LAW PRACTICE
A. College and Law Schools Attended:
From
To
Degree
_____________________________________ __________ __________ _____________
_____________________________________ __________ __________ _____________
_____________________________________ __________ __________ _____________
B. Date admitted to the State Bar of Texas: ____________________________________
C. Name of firm, partnership or professional corporation: _________________________
_______________________________________________________________________
D. How long have you maintained an office at the above address? ___Years ___Months
E. Other offices maintained during the period of five (5) years immediately
preceding the date of this application:
From To
Firm or Employer: _______________________________________ ________ ________
_________________________________________________ ___________ __________
Address
City/State/Zip Month/Year Month/Year
Firm or Employer: __________________________________________
_________________________________________________ ___________ __________
Address City/State/Zip
Month/Year Month/Year
F. I am an active member in good standing of the State Bar of Texas, currently maintaining
an office in the State of
G. I have been engaged in the actual practice of law on a full time basis for a
period of ________ years.
H. I have been found by a court to have rendered ineffective assistance of
counsel in a criminal law case.
_____ Yes _____ No If yes, attach a separate sheet with full details.
IV. SUBSTANTIAL INVOLVEMENT IN CRIMINAL LAW MATTERS
A. I estimate that my time practicing criminal law has been _____% _____% and
_____% of my practice for each of the three (3) immediately preceding years, respectively.
B. During the three (3) years immediately preceding the date of this
application, I have participated in the criminal law activities listed below to
the extent and in the capacity indicated:
NUMBER HANDLED (Approximate)
Supervisor
Lead
Co-
of
Counsel
Counsel
Jr. Counsel
1. Federal habeas corpus
applications--death penalty _______________ ______________
______________
2. Federal habeas corpus
applications--non-death penalty _______________
______________ ______________
3. State habeas corpus
applications--death penalty ________________ ______________
______________
4. State habeas corpus
applications--non-death penalty _______________
______________ ______________
5. Federal appeals ________________ ______________
______________
6. State appeals--death penalty ________________
______________ ______________
7. State appeals--non-death penalty ______________ ______________ ______________
8. Capital murder trials _______________ ______________ ______________
9. State district court trials ________________ ______________ ______________
10. Federal criminal trials _______________ ______________ ______________
11. Others__________________ ________________ ______________ ______________
V. CONTINUING LEGAL EDUCATION
Please list the courses you have attended and other CLE involvement you have
had during the past three (3) years. (Attached additional sheets if necessary)
VI. GRIEVANCE MATTERS
A. State whether you have been disbarred, suspended, reprimanded, or otherwise
disciplined by any segment of the bar, including, but not limited to any
local, district or state grievance authority of an organized bar. If
yes, give full details by attachment to this application. _____Yes _____
No
B. Do you now have any charges pending against you, either in court or
grievance committee, that could result in the filing of a malpractice
suit, a grievance committee proceeding or a suit for disciplinary action? If
yes, give full details by attachment to this application. _____Yes _____
No
C. State whether you have been adjudicated guilty of any offense of theft or
any other offense above the grade of a Class C Misdemeanor and whether
such resulted from a plea of guilty or nolo contendere or from a verdict after trial or otherwise
and regardless of the pendency of an appeal. If yes, give full details by
attachment to this application. _____Yes _____ No
VII. BOARD CERTIFICATION
(Areas in which certified by Texas Board of Legal Specialization.)
Areas
Date of Certification
____________________________________________ __________________________
VIII. GEOGRAPHICAL APPOINTMENTS
The State of
IX. A. I have read the rules and standards adopted by the Regional
Presiding Judges for appointment of counsel under Art. 11.071, C.C.P., and
certify that I am fully qualified for appointment. _____Yes _____ No
B. I agree to abide by the provisions of the rules and standards adopted by the
Regional Presiding Judges concerning the appointment of counsel under Art.
11.071, C.C.P. and all rules and standards which may be promulgated by the Regional
Presiding Judges from time to time. _____Yes _____ No
C. I agree that I will immediately notify the Office of Court Administration of
any reason which would render me unfit for appointment. _____Yes _____ No
D. In filing this application, I authorize all persons, firms, officers,
corporations, associations, organizations, state or federal agencies, and
institutions to furnish to the Office of Court Administration or any of its
authorized representatives all relevant documents, records or other information
that may be requested in the investigation of this application, specifically
including the records of grievances in possession of a Grievance Committee or
the general counsel of the State Bar of Texas. I further agree that all
information received by the Office of Court Administration shall be treated
confidentially and that I have no right of access to information received by
the Office of Court Administration from third parties.
_______________________________________________
Signature of Applicant
THE STATE OF TEXAS )(
COUNTY OF ________ )(
I, ______________________________________, being duly sworn, state that I have
read the foregoing application and have made each statement and representation
therein and answered each question therein fully and frankly and without
concealment or reservation, and such questions and answers are, to the best of
my knowledge true and complete.
_______________________________________________
Signature of Applicant
SUBSCRIBED AND SWORN TO before me, on this the ______________ day of
_____________________, 20____.
_______________________________________________
Notary Public in and for The State of Texas
My commission expires: _____________________
