**UNITED STATES ATTORNEY'S OFFICE**

**SOUTHERN DISTRICT OF CALIFORNIA**

**APPLICATION FOR APPOINTMENT**

**ASSISTANT U.S. ATTORNEY**

Date: \_\_\_\_\_\_\_\_\_\_\_\_ [ ]{.underline}

1\. Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

2\. Present Position and Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

Firm/Office:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

City County State Zipcode

Phone: ([ ]{.underline}) [ ]{.underline} Fax: ([ ]{.underline})
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

3\. Residence Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

City County State Zipcode

Phone: ([ ]{.underline}) [ ]{.underline} Fax: ([ ]{.underline})
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

4\. Date of Birth: [ ]{.underline} Place of Birth:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[ ]{.underline}

5\. Gender: [ ]{.underline} M [ ]{.underline} F

6\. California Bar Admission Date: [ ]{.underline} Bar No.:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ [ ]{.underline}

Other Bars to which you are admitted:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}

7\. Month/Year of any prior application for AUSA positions in SDCA?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ [ ]{.underline}

8.  Educational History -- Please provide [all]{.underline} colleges,
    law schools and graduate schools attended, beginning with the most
    recent first:

Degree Date Degree

[Colleges/Law Schools Attended]{.underline} [From]{.underline}
[To]{.underline} [Received]{.underline} [Received]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

(Revised 01/09/2004)

8.  List significant law school activities and awards:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
    ]{.underline}

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]{.underline}

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]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

8.  Provide all professional work history beginning with the most recent
    employment first:

[Employer]{.underline} [Position]{.underline} [Supervisor]{.underline}
[From]{.underline} [To]{.underline}

(include current address) (include current phone no.

and current address)

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
]{.underline}

**Provide the following information sequentially on plain, letter-size
paper (or if using downloaded version, type the answer after each
question). Each request or question and your response should be typed
and single-spaced. It is expected that all of the following requests and
questions will be answered fully and honestly. Do not read questions
narrowly. If you are uncertain of the information being sought, err on
the side of disclosure.**

8.  Identify any languages other than English that you speak fluently.

9.  List all courts in which you are presently admitted to practice,
    including the date of admission in each case. Provide the same
    information for administrative agencies having special admission
    requirements.

10. With respect to your entire career:

a\. How many years of criminal practice experience do you have?

b\. How many years of civil litigation experience do you have?

c\. State the number of cases you have tried to verdict in courts of
record during your career, including whether you were sole, associate or
lead counsel. How many of these cases were (1) civil, (2) criminal, (3)
jury, and (4) non-jury?

d\. Provide the citations to all reported cases in which you were
counsel of record in the trial or appellate courts.

14\. List up to 5 significant litigated cases in which you have appeared
as counsel and provide the name of the case; the case number; a brief
description of the case; the dates involved; the disposition; whether
the case was tried, and, if so, before a judge, jury or arbitrator; and
whether you were sole, lead or associate counsel.

15\. If you lack significant trial experience, describe the experiences
or special skills you possess which you believe qualify you for a
position as an Assistant U.S. Attorney.

16\. Have you ever taught at a law school? If so, which school? When?
What was the nature of your appointment? Which course(s) did you teach?

17\. Have you written any books, articles (including law review), or any
material on legal topics that have been published? If so, please list
them, giving full citations, dates, and a general description of the
subject matter.

18\. List any honors, prizes, awards, scholarships, fellowships and
other forms of recognition you have received.

19\. Have you ever held or applied for a commission, certificate,
credential or license which required proof of good character, other than
admission to practice law? If so, provide the date of application,
issuing authority, disposition of the application, and, if granted, your
number and present status.

20\. Have you ever been disciplined or cited as a member of a bar for a
breach of ethics or unprofessional conduct by, or been the subject of a
complaint to, any court, administrative agency, bar association,
disciplinary committee or other professional group? If so, provide the
particulars, including the applicable dates and disposition. (Identify
every complaint even if it was dismissed or did not result in
disciplinary action.)

21\. Have you ever been sanctioned by any court, or have you ever been
cited for contempt of any court or tribunal having the power of
contempt? If so, give the details, including dates and names, current
addresses and telephone numbers of the judges involved and counsel for
the adverse parties.

22\. Are you able, with or without reasonable accommodation, to perform
the requirements of an Assistant U.S. Attorney? These requirements
include, among other things:

C Attentively receiving, analyzing and concentrating on information for
a total of eight or more hours within a work day of reasonable duration;

C Conducting a trial, including the reviewing and presentation of all
types of evidence and the preparation and examination of witnesses;

C Reviewing and processing substantial volumes of information,
originally presented in written form (e.g., legal briefs, cases, jury
instructions, transcripts, agency reports);

C Producing a large quantity of original legal memoranda and other
documents;

C Absorbing, analyzing and weighing complex issues quickly and
accurately; and,

C Responding to situations with discretion, judgment and restraint while
under pressure.

23\. What role can an Assistant U.S. Attorney play in making our society
a better place?

24\. Why do you want to be an Assistant U.S. Attorney? Why do you
believe you are qualified?

25\. Attach a sample or samples of your legal writing (such as a portion
or all of an appellate brief, memorandum of points and authorities,
opinion letter, etc.). The sample(s) should not exceed a total of 25
pages.

26\. Please list five references (name, address and telephone number)
who are familiar with your performance as an attorney.

**I hereby declare under penalty of perjury that the answers and
statements provided by me in the forgoing application are true and
correct.**

**Type or**

**Print Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[
]{.underline}**

**Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_[ ]{.underline}**

The Department of Justice welcomes and encourages applications from
persons with physical and mental disabilities and will reasonably
accommodate the needs of those persons. If you need a reasonable
accommodation for any part of the application and hiring process, please
notify Renee Miranda, Human Resources Specialist, at (619) 557-6067. The
decision on granting reasonable accommodation will be made on a
case-by-case basis. The Department is firmly committed to satisfying its
affirmative obligations under the Rehabilitation Act of 1973, to ensure
that persons with disabilities have every opportunity to be hired and
advanced on the basis of merit with the Department of Justice.