| SECTION A - GENERAL INFORMATION |
| Personal Information |
| 1. | Personal Information |
| Full name | John Smith |
| Social Security Number | ***-**-**** |
| Date of birth | January 10, 1961 |
| Place of birth | Carlisle |
| Salutation | Mr. |
| NCBE Number | N10000000 |
| Other First, Middle, or Last Name |
| 2 | Have you ever been known by any other first, middle, or last name? |
| If yes, list in full each name used and dates the name was used. |
| From Mo/Yr |
| To Mo/Yr |
| Name |
| Was name change pursuant to court order? |
| If no, explain why no such order exists. If yes, in addition, you must submit with the paper portion of your application a copy of the court order. | ||
| Mailing Address |
| 3 | Address Type | residence |
| Firm name (if business) | Sonic Inc. |
| Street Address Line 1 | 3855 Lake Clearwater Place |
| Street Address Line 2 | Apt. 222 |
| City | Sarasota |
| State or Province | Florida |
| Zip or postal code | 90210 |
| County | Marion |
| Country | United States of America |
| Cell phone number | (812) 111-5101 |
| Home phone number | (812) 111-5100 |
| Work phone number |
| Fax number | 867360876 |
| 4 | Preferred Email address (Do not provide a temporary email address.) | sample@email.com |
| Marriage Information |
| 5 | Are you presently married or in a civil union or legally recognized domestic partnership? |
| If yes, provide date of marriage, date of civil union, or date of legalization of domestic partnership |
| Full name of spouse or partner |
| Divorce Information |
| 6 | Have you ever been divorced, had a marriage annulled or set aside, or had a civil union or legally recognized domestic partnership dissolved? |
| If yes, mail or upload to IBAB via your user account copies of all court documents relating to your divorce(s), annulment(s), or dissolution(s) of civil union or legally recognized domestic partnership. |
| Child Support, Alimony, or Family Support |
| 7 | Have you ever been required to pay child support, alimony, or family support as a result of a divorce, annulment, dissolution of civil union or legally recognized domestic partnership, or other court proceeding, or is such matter pending? |
| If yes, provide name and last known address of former spouse and/or of any other adult person to whom you have been required to make or to continue to make such payments, or who is a party to pending proceedings. |
| First Name |
| Last Name |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Country |
| Phone number(s) |
| Also if yes to 7, mail or upload to IBAB via your user home page a signed and notarized statement of your compliance with support payments from the person(s) to whom payments are made OR a record of payment from the court registry through which payments are made. |
| Parental Information - Parent 1 |
| 8 | Name of Parent 1 |
| Is Parent 1 deceased? |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Country |
| Phone number(s) |
| Parental Information - Parent 2 |
| 9 | Name of Parent 2 |
| Is Parent 2 deceased? |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Country |
| Phone number(s) |
| Citizenship Information |
| 10 | Are you a US citizen by birth? |
| If no, complete question 10 or 11 as applicable. |
| Are you a US citizen by naturalization? |
| If yes, mail or upload to IBAB via your user account a copy of your Certificate or Naturalization and provide the following information: |
| Certificate of Naturalization Number |
| Certificate of Naturalization Date of Issue |
| If you are not a US citizen by either birth or naturalization, what is your country of citizenship? |
| Are you a permanent resident of the US? |
| If yes, mail or upload to IBAB via your user account a copy, front and back, of your Permanent Resident Card (formerly known as Alien Registration Card or Green Card) and provide the following information: |
| Permanent Registration Card Number |
| Permanent Registration Card Date of Issue |
| 11 | Are you in the US on a Visa, including Student Visa? |
| If yes, mail or upload to IBAB via your user account a copy, front and back, of your Visa and provide the following information: |
| Visa Number |
| Visa Date of Issue |
| Visa Date of Expiration |
| Armed Forces |
| 12 | Have you ever been a member of the armed forces? |
| If yes, a separate Form 12 must be completed for each term of service. Mail or upload to IBAB via your user home page a copy of Report of Separation DD Form 214 for each term of service. |
| Current and Prior Addresses |
| 13 | Current Address |
| Provide your complete current address. |
| From Mo/Yr |
| To Mo/Yr |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Country |
| Prior permanent and temporary addresses. |
| List every prior permanent and temporary address at which you have lived during the last 10 years in reverse date order with the most recent first. |
| From Mo/Yr |
| To Mo/Yr |
| City |
| County |
| State or Province |
| Zip or Postal Code |
| Country |
| SECTION B - EDUCATIONAL INFORMATION |
| College and University |
| 14 | Provide the name of each college and university (other than law schools) that you attended, its location (including the name of the campus if the school had more than one), the dates attended, and the degree received; enter ND if you did not receive a degree. List schools beginning with the most recent. |
| Name |
| City |
| State or Province |
| Country |
| From Mo/Yr |
| To Mo/Yr |
| Degree |
| Law School |
| Name |
| Other Name of Law School |
| City |
| State or Province |
| Country |
| From Mo/Yr |
| To Mo/Yr |
| Degree |
| If your answer to question 15 includes more than one law school, explain why. If you were a visiting student or studying abroad, so state. If you transferred law schools, provide a detailed explanation, including applicable dates. | ||
| Was your law school ABA approved at the time of your graduation? |
| If you received your JD degree from a US law school that was not ABA-approved at the time of your graduation, you are not eligible for admission to the bar of Illinois. |
| If you graduated from a law school that was ABA-approved at the time of your graduation but is no longer in operation or ABA-approved, provide a full detailed explanation including the name and complete address of the law school from which you graduated and all pertinent dates. | ||
| Are you a Rule 715 applicant authorized from IBAB to make this application? |
| Provide the following answers and documentation: |
| Is the jurisprudence of the country in which the law school is located based on English Common Law? |
| If no, what law is the jurisprudence? | ||
| Did each period of study require classroom attendance at the law school(s) from which you received your degree? |
| If no, explain. | ||
| Have you pursued any other legal-based study or diploma certificate such as an LLM or Masters of Law in the United States or elsewhere? |
| Please provide the name of the educational institution and the type of degree or certification received. |
| Educational Institution |
| Degree or Certification |
| Release of Detailed Information to Law School |
| IBAB provides all law schools with the names of their respective students who pass/fail the Illinois bar exam. In addition, with the examinees' consent, IBAB releases to each law school detailed information on the examination performance of their examinees. Law schools use this information in preparing students for future examinations. Each school has pledged to keep the information confidential and to use it only to analyze the bar examination performance of its students. Your consent to the release of such information to your law school is altogether voluntary.NOTE: This paragraph does not apply to Rule 715 applicants. |
| 16 | Do you hereby authorize IBAB to release to your law school detailed information regarding your performance on the Illinois bar examination? |
| Misconduct |
| In answering question 17, you are advised that no advice of counsel, statute, court order, or legal or administrative proceeding withholding adjudication, expunging information from any record, sealing any record, or purporting to authorize any person to deny the existence or occurrence of any information or matter shall excuse less than full disclosure of the information required. |
| 17 | Have you ever been accused of or charged with any social, academic, or other misconduct, including, without limitation, the violation of any statute, ordinance, code of student conduct, or institutional policy, practice, or requirement, by any school, university, law school or other educational institution above the age of 13? |
| Have you ever been the subject of a probable cause hearing or other initial inquiry or have you ever accepted or elected a lowering of grade or other academic discipline in lieu of or in addition to participation in the disciplinary procedures of such institution? |
| Have you ever been dropped, suspended, warned, placed on social probation, academic probation, or disciplinary probation, expelled, requested to resign, or requested or advised by any such institution to discontinue your studies therein? |
| Have you, when age 13 or over, been accused of or charged with any form of misconduct or violation involving an institutional policy, practice, or requirement related to any standardized testing or exam, including but not limited to the PSAT/NMSQT (Preliminary SAT/National Merit Scholarship Qualifying Test), PSAT, SAT, ACT, GRE (Graduate Record Examination), or any exam produced or administered by the National Conference of Bar Examiners (such as the Multistate Professional Responsibility Examination (MPRE)) or Law School Admissions Council (such as the Law School Admission Test (LSAT))? |
| If yes to any part of question 17, provide the date and explain the circumstances surrounding each occurrence and the name of the educational institution where each incident occurred. Also provide the name, title, present address and phone number of the school official who would have complete information regarding each matter. Indicate whether you are also reporting this occurrence under question 45, 46 or 47. | ||
| SECTION C - PRIOR BAR REGISTRATION, APPLICATION, AND ADMISSION |
| Previous Applications |
| 18 | Have you previously filed a law student registration application in Illinois? |
| If yes, provide filing date of application. |
| 19 | Have you previously applied for admission to the bar of Illinois, either on examination, on motion or on any other basis? |
| If yes, provide the following information for each application. |
| Date of application |
| Date of examination |
| Results of examination, if any |
| Disposition of application |
| 20 | Have you ever submitted documents for permission to provide legal services pursuant to Illinois Supreme Court Rule 707, 718, and/or 756? |
| If yes, provide your Attorney Registration & Disciplinary Commission (ARDC) number, if received, the date(s) submitted, the Rule under which you sought permission. |
| ARDC Number, if received |
| Date documents submitted |
| Rule |
| Has permission to practice as reported above ever been terminated, or has a motion to terminate ever been filed? |
| If yes, provide the date(s), and explain the circumstances. | ||
| 21 | Have you ever been licensed to practice law in a jurisdiction other than Illinois? |
| If yes, Form 21 must be completed. |
| 22 | Have you ever submitted a law student registration application to any jurisdiction other than Illinois? |
| If yes, provide the following information for each application: |
| State or country |
| Date of application |
| Disposition of application, including withdrawal |
| If disposition is denied, withdrawn or pending, Explain. | ||
| 23 | Have you ever submitted to any jurisdiction other than Illinois an application for admission on examination, on motion, or any other basis, or withdrawn such an application that did not result, or has not, or not yet resulted, in your admission to the bar of that jurisdiction? |
| If yes, provide the requested information for each state or country to which application was made. |
| Name of jurisdiction |
| Type of application |
| If other, specify |
| Date of application |
| Disposition |
| Indicate whether application (a) is pending, (b) has been withdrawn, (c) has been denied due to failure of the bar exam, or (d) has been denied on character and fitness grounds. If (a), (b), or (d), explain under question 45. |
| SECTION D - LEGAL OR LAW-RELATED EMPLOYMENT |
| Legal or Law-related Employment |
| 24 | List all legal or law-related employment you have ever had and (excepting unpaid internships), including without limitation all temporary, part-time, full-time and self-employment, as a judge, lawyer, law clerk, intern, research assistant, paralegal, legal secretary, or other clerk or assistant, at or for any individual, lawyer, law firm, legal services office, legal clinic, partnership, corporation or other business entity, judge, court, government office, armed services, and law school. List jobs in reverse date order with current or most recent employment first. Please note that we will first attempt all verifications and references by email, so you must make every effort to obtain and provide all email addresses requested to IBAB. If you are unable to recall or obtain a supervisor's name or current address, after having made reasonable effort to do so, please so state. We will contact you if further information is required. If you are self-employed, or if above entity is now out of business, please provide name, address, phone number and email address of a verifying reference at bottom of this form. |
| Have you ever had, or do you currently have, legal or law-related employment? |
| If Yes, a separate Form 23 must be completed for each employment listed. |
| SECTION E - OTHER EMPLOYMENT |
| Temporary, Part-time, Full-time, and Self Employment |
| 25 | List every job (other than those listed in response to preceding question 23 and excepting unpaid internships and paid or unpaid jobs of less than six months' duration), including without limitation all temporary, part-time, full-time, and self-employment, you have held for the seven year period immediately prior to the date of the filing of this application. List jobs in reverse date order with current or most recent employment first. Please note that we will first attempt all verifications and references by email, so you must make every effort to obtain and provide all email addresses requested to IBAB. If you are unable to recall or obtain a supervisor's name or current address, after having made reasonable effort to do so, please so state. We will contact you if further information is required. If you are self-employed, or if above entity is now out of business, please provide name, address, phone number and email address of a verifying reference at the bottom of this form. |
| In the last seven years, have you had other than legal or law-related instance(s) of employment? |
| If yes, a separate Form 24 must be completed for each employment listed. |
| SECTION F - PERSONAL AND PROFESSIONAL REFERENCES |
| References |
| 26 | Provide the names and current addresses of three character references not related to you in any way, different from those who complete Attorney Character and Fitness Verifications on your behalf, different from those who complete self-composed affidavits verifying your practice, and different from those listed above as employers or former employers. There must be three references for each jurisdiction in which you ever practiced.If you hold a license to practice law in the jurisdiction but never practiced there, you do not need to provide a reference for that jurisdiction. Do not provide more than three such references for each jurisdiction. IBAB will ask these references to give information about your past activities and candid opinions of your character. If you are personally acquainted with any attorneys, you are encouraged to list one or two as references, but you will not be penalized for listing only non-attorneys. |
| Please note that we will first attempt all verifications and references by email, so you must make every effort to obtain and provide all email addresses requested to IBAB. |
| Name |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Phone number |
| Country |
| Email address |
| SECTION G - TWO EDUCATIONAL REFERENCES |
| Names and Addresses of Two Law School Professors |
| 27 | Provide the names and current addresses of two law school professors not related to you in any way. Do not provide more than two such references. If you are unable to list two law school professors, substitute other persons of comparable professional stature, not related to you in any way and different from those listed above as employers, former employers, or personal or professional references, with whom you were well acquainted during law school. |
| Please note that we will first attempt all verifications and references by email, so you must make every effort to obtain and provide all email addresses requested to IBAB. |
| Name |
| School affiliation |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Country |
| Phone number |
| Email address |
| Occupation (If listed reference is not a law school professor, state your relationship to the substitute reference and provide his or her occupation.) |
| Years Known |
| SECTION H - ILLINOIS SUPREME COURT ESSENTIAL ELIGIBILITY QUESTIONS |
| Termination/Resignation |
| 28 | In any paid or volunteer employment setting and including unpaid internships and jobs of less than six months' duration not listed in response to questions 23 and 24, have you ever been accused of misconduct, disciplined, permitted to resign in lieu of discipline or discharge, discharged or permitted or requested, formally or informally, to resign from or terminate employment? Please note that we will first attempt all verifications and references by email, so you must make every effort to obtain and provide all email addresses requested to IBAB. If you are unable to recall or obtain a supervisor's name or current address, after having made reasonable effort to do so, please so state. We will contact you if further information is required. If you are self-employed, or if above entity is now out of business, please provide name, address, phone number and email address of a verifying reference at bottom of this form. |
| If yes, explain and provide the date, circumstances, and name, current address, phone number and email address of employer, as well as the name and title of individual making such request if other than the listed employer. Also if yes, a separate Form 27 must be completed for each termination/resignation listed. | ||
| Other License |
| 29 | Have you ever applied for (or applied for and then withdrawn) or held a license, certification or permit for a business, trade, profession, or occupation other than attorney at law, the procurement of which required proof of good character and/or examination (e.g., CPA, real estate broker, physician, teacher, patent practitioner)? |
| If yes, provide the following information. |
| Type of license |
| License number |
| Mo/Yr |
| Issuing authority |
| Address 1 |
| Address 2 |
| City |
| State or Province |
| Zip or postal code |
| Country |
| Phone number |
| Email Address |
| Business, Trade, or Professional License |
| 30 | Have you ever been denied a business, trade, professional or occupational license, certification or permit other than as attorney at law (e.g., CPA, real estate broker, physician, teacher, patent practitioner)? |
| 31 | Have you ever had a business, trade, professional or occupational license, certification or permit revoked? |
| 32 | Have you ever permitted a business, trade, professional or occupational license, certification or permit to expire? |
| Professional Discipline |
| 33 | To the best of your knowledge, have there ever been or are there now any formal or informal charges, complaints, or grievances pending concerning your conduct as a member of another profession or as a holder of public office? |
| 34 | Have you ever been suspended, censured, or otherwise reprimanded, disqualified or disciplined as a member of another profession or as a holder of public office? |
| If yes to 29, 30, 31, 32 or 33, explain and state the date of each occurrence and the name, current address, phone number and email address of the authority in possession of the records regarding the matter and provide a brief narrative explanation of the circumstances surrounding each occurrence. | ||
| Surety on Bond |
| 35 | Has any surety on any bond on which you were the principal or obligor been required to pay any money on your behalf? |
| If yes, a Form 34 must be completed for each bond. |
| Past Due Debt |
| 36A | Do you CURRENTLY have any debt or obligation greater than $500, including, without limitation, credit card debts, charge accounts, medical bills, student loans, bank loans, and court-ordered obligations to pay child support, alimony and family support reported AS MORE THAN 2 MONTHS PAST DUE? |
| If yes, a separate Form 35A must be completed for each debt or obligation. |
| 36B | Have you ever had a credit card revoked or any debt referred to collection or charged off? |
| If yes, a separate Form 35B must be completed for each account. |
| 36C | Have you ever defaulted on any student or other loan? |
| If yes, a separate Form 35C must be completed for each defaulted loan. |
| Income Tax Returns |
| 37 | Except if you were not required to file due to not meeting the minimum income threshold, have you ever failed to file any federal, state or local income tax return as required by law, failed to pay any taxes when due, including employers' withholding taxes, or entered into any repayment agreement with a taxing authority? |
| If yes, for each instance provide the year, the reason for the failure to file or to pay when due, and the status or final outcome of the matter. In addition, mail or upload to IBAB via your user home page documentation establishing that taxes are current. | ||
| Bankruptcy |
| 38 | Have you ever filed for relief under federal bankruptcy law? |
| If yes, a separate Form 38 must be completed for each bankruptcy. |
| Complaint Alleging Fraud |
| 39 | Have you ever had a complaint filed against you in any civil, criminal or administrative forum alleging fraud, deceit, misrepresentation, forgery, discrimination, or professional malpractice? |
| If yes, a separate Form 39 must be completed for each instance. In addition, mail or upload to IBAB via your user home page copies of all pleadings, allegations, and order(s) of final disposition. Additional documents may be requested. |
| Civil Litigation |
| 40 | Have you ever been a plaintiff, defendant, or other party in any litigation or administrative forum, excluding criminal litigation and matters disclosed in response to preceding question 38? |
| If yes, a separate Form 40 must be completed. |
| Decrees, Judgments, Liens or Orders |
| 41 | Are there any decrees, judgments, liens, or orders entered against you which have not been satisfied including judgments listed in response to questions 38 and 39? |
| If yes, provide date, names of parties, court or agency, amount outstanding, and reason(s) for your failure to satisfy. | ||
| Contempt of Court |
| 42 | Have you ever been held in contempt of court? |
| If yes, explain the circumstances, including date, court, nature of proceeding, and final disposition. In addition, mail or upload to IBAB via your user home page copies of all court orders. | ||
| Rule 711 License |
| 43 | Have you ever applied for a Rule 711 license from the Administrative Office of Illinois Courts? |
| Illinois Rules of Professional Conduct |
| 44 | Have you read and do you understand the Illinois Rules of Professional Conduct? |
| Denied Admission to the Bar of Another Jurisdiction |
| 45 | Have you ever been denied admission or not admitted for any reason to the bar of another jurisdiction on a ground related to character and fitness, are you the subject of a pending character and fitness hearing or have you withdrawn an application? |
| If yes, provide the requested information for each state or country to which application was made. |
| Name of jurisdiction |
| Date of application |
| Date of denial or withdrawal, if applicable |
| Hearing date scheduled, if applicable |
| Also if yes, explain. | ||
| Criminal Matters |
| NOTE: In connection with your answers to questions 46, 47 and 48, you are advised that no advice of counsel, statute, court order, or legal proceeding withholding adjudication reducing charges, expunging information from any record, sealing any record, or purporting to authorize any person to deny the existence or occurrence of any information or matter shall excuse less than full disclosure of the information required. You must answer questions 46, 47, and 48; the submission of letters from law enforcement agencies in lieu of an answer is not acceptable. If you are required to report an incident in response to more than one of the three questions, you are required to complete only one explanatory form regarding that incident. |
| 46 | Have you ever been convicted of a felony or is there now pending against you any indictment, criminal information, or criminal complaint charging a felony offense? |
| If yes, a separate Form 46 must be completed for each instance. In addition, mail or upload to IBAB via your user home page copies of the arresting officer's report, complaint, indictment, trial disposition, sentence, and appeal, if any. |
| 47 | During the last 25 years, have you been formally or informally detained, restrained, cited, summoned into court, taken into custody, arrested, accused, charged, convicted, placed on probation, placed on supervision, or forfeited collateral in connection with any offense against the law or an ordinance, or accused of committing a delinquent act, other than traffic offenses set forth in response to question 48 and as set forth in your Driving Record provided under question 49. |
| If yes, a separate Form 47 must be completed for each instance. In addition, mail or upload to IBAB via your user home page copies of the arresting officer's report, complaint, indictment, trial disposition, sentence, and appeal, if any. |
| 48 | Have you ever been charged with a traffic violation involving felonious conduct, or the use of alcohol or drugs, or which resulted in time spent in custody, a fine of $350 or more, or the revocation or suspension of your driver's license? |
| If yes, complete Form 48 for each instance. In addition, mail or upload to IBAB via your user home page copies of the arresting officer's report, the results of any blood or breathalyzer tests, any alcohol or drug evaluations or assessments performed in connection with the charge, the order of disposition, and documentation substantiating successful completion of any sentence or condition imposed. |
| Driving Record |
| 49 | List all jurisdictions in which you were licensed to drive in the last 10 years. Obtain and mail or upload to IBAB via your user home page a Court Purpose driving record (not a general driving record) from each such jurisdiction. |
| Do you have Driver's License? |
| From mo/yr |
| To mo/yr |
| Name of jurisdiction |
| Driver's License Number |
| Outstanding Parking Violations |
| 50 | Do you have any outstanding parking violations? |
| If yes, explain the facts, including without limitation the number of such tickets, ticketing authority, license plate number of the ticketed vehicle, loacation (city and state) where ticketed, dates incurred, and the amounts due. If you are currently contesting any such outstanding parking ticket(s), explain the basis upon which you are contesting each ticket. | ||
| Support the Constitution of the United States and the Constitution of the State of Illinois |
| 51 | Do you now and will you hereafter support the Constitution of the United States and the Constitution of the State of Illinois? |
| If no, explain | ||
| Continuous Reporting Obligation |
| 52 | Do you understand that after your Character & Fitness Questionnaire is filed, you will have a continuous reporting obligation and must notify IBAB of any changes or additions to the information provided in your application? This includes, but is not limited to, address changes, employment changes, criminal charges, disciplinary actions (educational, employment or other), and traffic violations, including any parking tickets that are not paid upon receipt. |
| If no, explain | ||
| SECTION I - REQUIRED DOCUMENTATION |
| Required Documentation |
| All documentation including copies required to be submitted hereunder must be completely legible. Any documents which are submitted in a language other than English must be accompanied by a duly authenticated translation into English. IBAB will not consider and act on applications until all required documents have been filed. You are advised to retain a copy of this application and all documentation for your records as copies will not be available at any time following submission. I understand my application is not complete until all required documentation has been received by IBAB and that my failure to timely submit any part thereof may delay or prevent my certification for admission. |
| If no, explain | ||
| SECTION J - ATTESTATION |
| Attestation |
| I have read and understood this application, and have carefully reviewed my answers to ensure their truth and completeness. I certify, under penalties provided by law pursuant to Section 1-109 of the Code of Civil Procedure (735 ILCS 5/1-109) that the information contained in this application is true and complete. |