i. | the attorney's full name, firm name, residence address, principal business address, e-mail address, telephone numbers, FAX numbers, the state jurisdiction or jurisdictions in which the attorney is licensed, and bar identification numbers; |
ii. | affirmation that the attorney is duly licensed, in good standing and authorized to practice law in each stated jurisdiction, and that the attorney's license is not subject to suspension or restriction; |
iii. | affirmation that in performing all services under the authorization of this rule, the attorney will be acting as a volunteer; |
iv. | affirmation that all services to be performed will be at no charge or expense to the client; |
v. | affirmation that the attorney has read and will abide by the Louisiana Rules of Professional Conduct, including the rules prohibiting solicitation of cases or clients, will faithfully perform the duties of an attorney, and will not place his or her personal interests ahead of the interests of the client; |
vi. | affirmation that the attorney has read and will familiarize himself/herself with the Emergency/Disaster Training Manual for Volunteer lawyers prepared by the Louisiana State Bar Association (available at http://www.lsba.org); |
vii. | affirmation that the attorney consents to the lawyer disciplinary jurisdiction of the State of Louisiana; |
viii | affirmation that the attorney shall not offer to provide civil legal assistance in this State to any person or for any matter other than through the established not-for-profit bar association(s) or legal services organization(s) specifically designated by this Court and shall not hold himself or herself out in this State to be authorized to provide legal services to any person other than through the established not-for-profit bar association(s) or legal services organization(s) specifically designated by this Court; and |
ix. | a certificate of good standing as well as a disciplinary certificate, issued within 90 days of submission of the application, from each state where the lawyer is licensed to practice. |