Del. R. Sup. Ct. Form 5
IN THE SUPREME COURT OF THE STATE OF DELAWARE
EMPLOYER REPORT OF CHANGE OF REGISTRANT STATUS UNDER RULE 55.1
Employer of Registrant holding a Delaware Certificate of Limited Practice hereby gives notice to the Court that [the employment of [REGISTRANT'S NAME AND DELAWARE BAR IDENTIFICATION NUMBER] has ended effective as of [Date].]
[the active membership of [REGISTRANT'S NAME AND DELAWARE BAR IDENTIFICATION NUMBER in the Bar of [Jurisdiction] has changed to inactive/emeritus/senior status effective as of [Date]]
[it has been advised that [REGISTRANT'S NAME AND DELAWARE BAR IDENTIFICATION NUMBER] is the subject of disciplinary measures imposed by the Bar of [Jurisdiction] effective as of [Date].]
Signature of Corporate Officer
Dated: _________
____________________
Name and Title
[Address]
[Telephone Number]
[Electronic Mail Address]
Del. R. Sup. Ct. Form 5