UNITED STATES DISTRICT COURT

CENTRAL DISTRICT OF CALIFORNIA

Plaintiff(s)	CASE NUMBER

Defendant(s).	(PROPOSED) ORDER ON APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE PRO HAC VICE
The Court, having determined whether the required fee has been paid, and having reviewed the Application of Non-Resident Attorney to Appear in a Specific Case Pro Hac Vice filed by

of
Applicant's Name (Last Name, First Name & Middle Initial
Telephone Number	Fax Number
E-Mail Address	Firm/Agency Name & Address

for permission to appear and participate in this case on behalf of

Name(s) of Party(ies) Represent __ Plaintiff(s) __ Defendant(s) __ Other:

and designating as Local Counsel

of
Designee's Name (Last Name, First Name & Middle Initial
Designee's Cal. Bar No.	Telephone Number	Fax Number
E-Mail Address	Firm/Agency Name & Address

HEREBY ORDERS THAT the Application be:

__ GRANTED
__ DENIED:	__	for failure to pay the required fee.
__	for failure to attach a Certificate of Good Standing issued within 30 days prior to filing of Application.
__	for failure to complete Application:
__	pursuant to L.R. 83-2.1.3.2: __ Applicant resides in California; __ previous Applications listed indicate Applicant is regularly employed or engaged in business, professional, or other similar activities in California.
__	pursuant to L.R. 83-2.1.3.4; Local Counsel: __ is not member of Bar of this Court; __ does not maintain office District.
__	because

IT IS HEREBY FURTHER ORDERED THAT the Application fee, if paid: __ be refunded __ not be refunded.

Dated:
U.S. District Judge/U.S. Magistrate Judge

G-64 Order (05/16)	(PROPOSED) ORDER ON APPLICATION OF NON-RESIDENT ATTORNEY TO APPEAR IN A SPECIFIC CASE PRO HAC VICE	Page 1 of 1