Md. R. Att'y, Form 19-a.1
(Caption)
MOTION FOR SPECIAL ADMISSION OF OUT-OF-STATE ATTORNEY
UNDER RULE 19-217
I, .........., attorney of record in this case, move that the court admit, .......... (name) .........., an out-of-state attorney who is a member in good standing of the Bar of .........., for the limited purpose of appearing and participating in this case as co-counsel with me.
Out-of-State Attorney Information:
..................................
(Full Name)
..................................
(Address)
..................................
(Telephone) ..................................
(Email Address)
Unless the court has granted a motion for reduction or waiver, the $100.00 fee required by Code, Courts and Judicial Proceedings Article, § 7-202(f) is included with this motion.
I [ ] do [ ] do not request that my presence be waived under Rule 19-217(d).
..............................
Signature of Moving Attorney
..............................
Name
..............................
Address
..............................
Telephone
..............................
Email Address
Attorney for ..............................
CERTIFICATE AS TO SPECIAL ADMISSIONS
I, .........., certify on this .......... day of .........., .........., that during the preceding five years, I have been specially admitted in the State of Maryland .......... times by the following courts:
Date
..........
..................................
..........
Court
..................................
..........
..................................
..............................
I have previously been issued the following unique identifying numbers by the Maryland Judiciary:
Attorney Information System ...................................
Client Protection Fund ........................................
Maryland Electronic Courts (MDEC)..............................
Signature of Out-of-State Attorney
..............................
Name
..............................
Address
..............................
Telephone
..............................
Email Address
(Certificate of Service)
Md. R. Att'y, Form 19-a.1
This Form is derived from former Form RGAB-14/M (2016).