| ADMISSION & DISCIPLINE RULE 17.1 |
| ADMISSION & DISCIPLINE RULE 17.1 |
Admission & Discipline Rule 17.1: Section 1. An applicant who has taken the UBE in a jurisdiction other than Indiana and achieved a scaled score of at least 264 may be admitted to the Indiana bar if he or she satisfies the following conditions:
Section 2. Any applicant for admission by a transferred UBE score shall be required to complete the Indiana Law Course, a jurisdiction-specific component on Indiana law, not later than six (6) months after the date of the applicant’s admission to the Indiana bar. If an applicant fails to complete the Indiana Law Course within the required time period, the Board of Law Examiners may certify such fact to the Supreme Court with the recommendation that the applicant’s license be suspended pending completion of the course. Section 3. Applications for admission by a transferred UBE score shall be filed through the electronic application procedures prescribed by the Board of Law Examiners. The application shall be in such form and shall request such information as may be required by the Board of Law Examiners. The Board of Law Examiners may require additional information deemed by it to be necessary. Section 4. An affidavit of the dean of the applicant's law school, or the dean's designee, to the effect that there is nothing in the school records or personal knowledge of the dean or faculty of such school to indicate that the applicant is not of good moral character or that the applicant is not fit for admission to the practice of law must be filed with the Board of Law Examiners. The Board shall provide forms for such certification. Section 5. A certified transcript of the law school record of the applicant showing the date of graduation and the degree conferred must be filed with the Board of Law Examiners before the applicant can be admitted to the bar. Section 6. Applications for admission by a transferred UBE score shall be accompanied by a filing fee of five hundred dollars ($500). |
| I have read the above Rule and am eligible to transfer my scores to Indiana. |
| PERSONAL INFORMATION |
| Personal Information |
| 1. | Please enter your personal information. |
| Full Name | John Smith |
| Social Security Number | ***-**-**** |
| NCBE Number | N10000000 |
| Birth Date | January 10, 1961 |
| Birth Place | Carlisle |
| Salutation | Mr. |
| Contact Information |
| 2. | The following is the address to which all correspondence will be mailed. You must make any address changes immediately by accessing the "Edit Personal Info" link. |
| Street or P.O. Box # | 3855 Lake Clearwater Place |
| Apt. # or Address 2 | Apt. 222 |
| City | Sarasota |
| State | Florida |
| zip | 90210 |
| Preferred Contact Number | (812) 111-5100 |
| Alternate Number | (812) 111-5101 |
| 3. | You must have a personal interview at least 30 days before the examination date. Personal interviews are conducted locally by members of the Character and Fitness Committee. |
| Interview County in Indiana |
| Other First, Middle or Last Name |
| 4. | Have you ever been known by any other first, middle or last name? |
| List each name used, or by which you have at any time been known, and the dates that name was used. |
| Last Name |
| First Name |
| Middle Name |
| From Mo/Yr |
| To Mo/Yr |
| Reason name was used | ||
| Parental Information |
| 5. | Please provide your parents' names |
| Your father's full name |
| Your mother's full name |
| Armed Forces |
| 6. | Have you ever served in the armed forces of the United States or any other country? |
| Branch of Service |
| From Mo/Yr |
| To Mo/Yr |
| Type of Discharge or Separation | ||
| If discharge was other than "honorable", explain the circumstances with a written description of the facts in the space provided and upload any documents or photo copies thereof. | ||
| OTHER JURISDICTIONS |
| Other Jurisdictions |
| 7. | Have you ever applied for admission to practice law by motion, by reciprocity, by diploma privilege or by taking a bar exam in Indiana or any other jurisdiction? (Include any pending or prior applications. Do not include this application.) Please upload a Certificate of Good Standing if admitted |
| REFERENCES |
| Personal References |
| 8. | Provide the names and addresses of six references who can advise the Board concerning your moral character and fitness to practice law. If you have an incident in your past that affects your Character and fitness, please make sure the references you list below are aware of the incidences. References may not include relatives or law school classmates. |
| Prefix |
| First Name |
| Last Name |
| Address 1 |
| Address 2 |
| City |
| State |
| Zip Code |
| Email Address |
| Telephone Number |
| Fax Number |
| RESIDENTIAL HISTORY |
| Permanent and Temporary Addresses |
| 9. | Please supply a list of your residences in chronological order starting at age 18. |
| Resided From |
| Resided To |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip Code |
| Country |
| EDUCATIONAL INFORMATION |
| Educational Information |
| 10.A | I will receive/received my law school degree (J.D.) on |
| College (Excluding ABA Approved Law School) |
| 10.B | Provide the following information for each college and university attended (other than ABA approved law school). |
| College Name |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip Code |
| Dean of Students' Email |
| Attended From |
| Attended To |
| Degree Conferred |
| Was this a study abroad program or a college outside of the United States? |
| Please enter any additional information about the program in the Notes field below, including, if necessary, the location of the program and the college through which (if any) the program was taken. |
| Notes | ||
| ABA Approved Law School |
| 10.C | Provide the following information for ABA approved law school. |
| School Name |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip Code |
| Dean of Students' Email |
| Attended From |
| Attended To |
| Degree Conferred or Expected to be Conferred |
| Was this a study abroad program or was it a college outside of the United States? |
| Please enter any additional information about the program in the Notes field below, including, if necessary, the location of the program and the college through which (if any) the program was taken. |
| Notes | ||
| Additional Information | ||
| EMPLOYMENT |
| Notification |
Please supply a complete list of your entire employment history, starting at age 18, in chronological order. Employment encompasses all part-time and full-time employment, including self-employment, externships and internships (paid and unpaid), clerkships, military service, volunteer work and temporary employment. You must include contact information for any position for which you were not voluntarily released. |
| Employment History |
| Have you ever been employed, including but not limited to paid or unpaid volunteer? |
| 11. | Employer Name |
| Address 1 |
| Address 2 |
| City |
| State |
| Zip Code |
| Country |
| Phone # of Supervisor or Employment Verification Contact |
| Email Address of Supervisor or Employment Verification Contact |
| Type of Work | ||
| Date Started |
| Date Ended |
| Reason for leaving the job | ||
| If the reason for leaving the job was anything but voluntary, provide a detailed written description of the facts and circumstances relating to your leaving the job. UPLOAD copies of any paperwork or documentation that is related to such situations. |
| Description | ||
| DRIVING RECORDS |
| Driver's License |
| 12. | Have you ever held a Driver's License? |
| For each jurisdiction, including Indiana, in which you have held a driver's license during the last 5 years, you must submit an Official Driving Record. |
| Driver's License Number |
| State |
| Country |
| If above does not apply, disregard. |
| Expiration Date |
| QUESTIONS AND RESPONSES |
| Question and Responses 1 |
| 13.A | Have you ever been disciplined, expelled, dropped, suspended, warned, placed on academic suspension, academic probation, or allowed to resign from any college, university or law school? |
| If you answered Yes, please provide the following in the space below: Name of the Institution, Regulatory Body, Profession or Office, Type of Action, Date Action Taken, Detailed Explanation of the Circumstances. |
| Name of the Institution, Regulatory Body, Profession or Office |
| Type of Action |
| Date Action Taken |
| Detailed Explanation of the Circumstances | ||
| Upload copies of all paperwork related to the incident. if you are unable to obtain paperwork, please indicate in the comments section, the steps you went through in order to try to obtain the requested paperwork. |
| 13.B | Have you ever been accused by any college, university, law school, other education institution, or testing service of any act of academic misconduct, including, but not limited to, plagiarism or cheating on any examination or test? |
| If you answered Yes, please provide the following in the space below: Name of the Institution, Regulatory Body, Profession or Office, Type of Action, Date Action Taken, Detailed Explanation of the Circumstances. |
| Name of the Institution, Regulatory Body, Profession or Office |
| Type of Action |
| Date Action Taken |
| Detailed Explanation of the Circumstances | ||
| Upload copies of all paperwork related to the incident. If you are unable to obtain paperwork, please indicate in the comments section, the steps you went through in order to try to obtain the requested paperwork. |
| 13.C | Have you ever been disciplined, suspended, warned, or allowed to resign from any profession? |
| If you answered Yes, please provide the following in the space below: Name of the Institution, Regulatory Body, Profession or Office, Type of Action, Date Action Taken, Detailed Explanation of the Circumstances. |
| Name of the Institution, Regulatory Body, Profession or Office |
| Type of Action |
| Date Action Taken |
| Detailed Explanation of the Circumstances | ||
| Upload copies of all paperwork related to the incident. If you are unable to obtain paperwork, please indicate in the comments section, the steps you went through in order to try to obtain the requested paperwork. |
| 13.D | Have you ever been removed from appointive or elective public office for cause, or have you been disciplined, suspended or disbarred as an attorney? |
| If you answered Yes, please provide the following in the space below: Name of the Institution, Regulatory Body, Profession or Office, Type of Action, Date Action Taken, Detailed Explanation of the Circumstances. |
| Name of the Institution, Regulatory Body, Profession or Office |
| Type of Action |
| Date Action Taken |
| Detailed Explanation of the Circumstances | ||
| Upload copies of all paperwork related to the incident. If you are unable to obtain paperwork, please indicate in the comments section, the steps you went through in order to try to obtain the requested paperwork. |
| 14. | Have you ever been a party in a civil court case or proceeding? |
| A. Divorce |
| Please complete a B-2 form for EACH instance. |
| B. Guardianship |
| Please complete a B-2 form for EACH instance. |
| C. Personal Injury |
| Please complete a B-2 form for EACH instance. |
| D. Landlord / Tenant |
| Please complete a B-2 form for EACH instance. |
| E. Personal protective case |
| Please complete a B-2 form for EACH instance. |
| F. Other |
| Please complete a B-2 form for EACH instance. |
| Question and Responses 2 |
| 15. | Have you ever had a complaint or other action (including but not limited to, allegations of fraud, deceit, misrepresentation, forgery or malpractice) initiated against you in any administrative forum? |
| You must complete a B-2 form for EACH incident. |
| Notice Regarding Expunged Arrests and Convictions Indiana's expungement statute, Ind. Code § 35-38-9, does not apply to the State Board of Law Examiners for purposes of determining whether an applicant possesses good moral character for admission to the bar. In response to Questions No. 16-19 on the application, all applicants are, therefore, required to include and disclose all matters, including any arrests or convictions that may have been expunged, dismissed or otherwise set aside. |
| 16. | Have you ever received a warning, a ticket or been cited for, arrested for, charged with, or convicted of any traffic violation? Include all matters that have been expunged (including any matters expunged by a court pursuant to Ind. Code § 35-38-9), dismissed, subject to a diversion or deferred prosecution program, or otherwise set aside. Parking violations DO NOT need to be included. |
| You must complete a B-3 form for each incident. |
| 17. | Have you ever been adjudicated delinquent in a juvenile court? Include all matters that have been expunged (including any matters expunged by a court pursuant to Ind. Code § 35-38-9), dismissed, subject to a diversion or deferred prosecution program, or otherwise set aside. |
| Make as many copies as necessary to report each instance on a separate form. |
| You must complete a B-3 form for each incident. |
| 18. | Have you ever been convicted of any violation of law, including, but not limited to, all felonies, misdemeanors, infractions, and violations of military law? Include all matters that have been expunged (including any matters expunged by a court pursuant to Ind. Code § 35-38-9), dismissed, subject to a diversion or deferred prosecution program, or otherwise set aside. (Traffic violations are included in question 16 and do not need to be repeated here) |
| Make as many copies as necessary to report each instance on a separate form. |
| You must complete a B-3 form for each incident. |
| 19. | In addition to the matters set forth in Questions 16, 17, and 18 above, have you ever been arrested for or accused of violations of law, been the subject of investigation of a violation of law, including, but not limited to, all felonies, misdemeanors, infractions, juvenile matters, military matters and anything else? Include all matters that have been expunged (including any matters expunged by a court pursuant to Ind. Code § 35-38-9), dismissed, subject to a diversion or deferred prosecution program, or otherwise set aside. |
| Make as many copies as necessary to report each instance on a separate form. |
| You must complete a B-3 form for each incident. |
| Question and Responses 3 |
| 20. | Have you ever filed a petition for bankruptcy? |
| Make as many copies as necessary to report each instance on a separate form. |
| 21.A | Have you ever had a credit card or charge account revoked? |
| Please complete Form B-5. |
| 21.B | Have you ever defaulted on any student loans? |
| Please complete Form B-5. |
| 21.C | Have you ever defaulted on any other debt? |
| Please complete Form B-5. |
| 22. | Within the meaning of the term "good moral character" and "fitness" to practice law as set out and defined in Rule 12 of the Admission and Discipline Rules, since age 16 have you ever been involved in any incidents where there was any challenge to your character, honesty and integrity? Do not include any arrests or convictions that have been expunged by a court pursuant to Ind. Code § 35-38-9. Your answering of this question certifies that you have read and understand Rule12. (Do not include the answers disclosed in Questions 13-21.) |
| Description of incident | ||
| Date of incident |
| City |
| State |
| Involved persons | ||
| How the matter was resolved? | ||
| Upload all copies of all documents relating to the incident. (Label "Supplement to Question 23.") |
| GENERAL QUESTIONS |
| PREAMBLE |
| Preamble to Questions 23 and 24. Through this application, the State Board of Law Examiners makes inquiry about mental health and addiction matters. The information received is treated confidentially and will be disclosed only to the applicant and those jurisdictions and/or individuals for which the applicant has provided a release. The purpose of our inquiries is to determine the current fitness of an applicant to practice law. The mere fact of treatment for mental health problems or addictions is not, in itself, a basis on which an applicant is ordinarily denied admission. The State Board of Law Examiners may deny certification to applicants whose ability to function is impaired in a manner relevant to the practice of law or to applicants who fail to carry their burden of proving that they are possessed of good moral character and fitness. The terms "good moral character" and "fitness" and the relevant considerations in the determination of good moral character and fitness are defined and set out in Admission and Discipline Rule 12. This character and fitness inquiry is consistent with the public purpose that underlies the licensing responsibilities assigned to the State Board of Law Examiners by the Indiana Supreme Court. |
| General Questions |
| 23. | Within the past five years, have you exhibited any conduct or behavior that could call into question your ability to practice law in a competent, ethical and professional manner? |
| If you answered yes, furnish a thorough explanation below: | ||
| 24. | Within the past ten years, have you asserted any condition or impairment as a defense, in mitigation, or as an explanation for your conduct in the course of any inquiry, any investigation, or any administrative or judicial proceeding by an educational institution, government agency, professional organization, or licensing authority; or in connection with an employment disciplinary or termination procedure? |
| If you answered yes, furnish a thorough explanation below: | ||
| 25. | We require a Dean Certification from your law school that must be submitted to our office 20 days prior to the bar exam. Please enter the e-mail address for the Office of Student Affairs at your law school who would complete this form. |
| Email Address |
| Attestation |
| I affirm under the penalties of perjury that each and every statement made in this application is true, complete and accurate to the best of my knowledge. |