Name: ______________________________________
Address: ______________________________________
______________________________________
______________________________________
I certify I will no longer be actively practicing law in North Dakota and request that I be placed on inactive status. I have reviewed Rule 4(b) of the North Dakota Rules for Continuing Legal Education and understand: 1) I will no longer be licensed to practice law in North Dakota; and 2) the ethical obligations associated with my inactive status. I also certify that I am not subject to any disciplinary proceedings or investigations in any jurisdiction.
Dated this _____ day of _____________, 19___.
Signed by: _____________________________
Subscribed to and sworn before me this ____ day of ____________, 19___.
_________________________________________
Notary Public
My commission expires: __________________
N.D. R. Cont. Legal. Educ. 9 app A