CIRCUIT RULE 26.1 DISCLOSURE STATEMENT
Appellate Court No: _________________ Short Caption:_________________________________________________ To enable the judges to determine whether recusal is necessary or appropriate, an attorney for a non-governmental party or amicus curiae, or a private attorney representing a government party, must furnish a disclosure statement stating the following information in compliance with Circuit Rule 26.1 and Fed. R. App. P. 26.1 . The Court prefers that the disclosure statement be filed immediately
following docketing; but, the disclosure statement must be filed within
21 days of docketing or upon the filing of a motion, response, petition,
or answer in this court, whichever occurs first. Attorneys are required
to file an amended statement to reflect any material changes in the required
information. (2) The names of all law firms whose partners or associates have appeared
for the party in the case (including proceedings in the district court
or before an administrative agency) or are expected to appear for the
party in this court: (3) If the party or amicus is a corporation: i) Identify all its parent corporations, if any; and ii) list any publicly held company that owns 10% or more of the party's
or amicus' stock: Attorney's Signature:_______________________________________ Date:_____________________________ Attorney's Printed Name:__________________________________________________________________________________________ Please indicate if you are Counsel of Record for the above listed parties pursuant to Circuit Rule 3(d). Yes_____ No _____. Address:__________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Phone Number:__________________________________Fax Number:__________________________ E-Mail Address:_____________________________________________________________________ |
rev. 11/01 AK |