______________________________________ 

 

 

 

 

 

 

 

 

 

 

 

 


 


 


 


 

UNITED STATES DISTRICT COURT
 

DISTRICT OF OREGON
 

Civil Case No. ____________ 

____ 

v. 

_____________________________ 

Plaintiff(s), 

_____ APPLICATION FOR SPECIAL 

ADMISSION – PRO HAC VICE 

Defendant(s). 

Attorney requests special admission pro hac vice in 

the above-captioned case. 

Certification of Attorney Seeking Pro Hac Vice Admission: I have read and understand the 

requirements of LR 83-3, and certify that the following information is correct: 

(1) PERSONAL DATA: 

Name: 

(Last Name) 

Firm or Business Affiliation: 

(First Name) (MI) (Suffix) 

Mailing Address: 

City: 

Phone Number: 

State: 

 Fax Number: 

Zip: 

Business E-mail Address: 

U.S. District Court–Oregon Application for Special Admission - Pro Hac Vice 

Revised March 1, 2014 Page 1 of 3 

3:15-cv-00262-SI

MEMORY INTEGRITY LLC, a 

Delaware corporation

INTEL CORPORATION 

 Caryn L. Cross Cross Caryn L

 Farney Daniels PC Brooklyn 718-362-1650 98 Rockwell Place, 2nd Floor 11217 718-362-1671 NY ccross@farneydaniels.com

Case 3:15-cv-00262-SI Document 204 Filed 04/05/16 Page 1 of 3
 

 

 

 

 

 

 

 

 

	 

	 

	 

	 

	 

	 

	 

	 

(2) BAR ADMISSIONS INFORMATION: 

(a) State bar admission(s), date(s) of admission, and bar ID number(s): 

(b) Other federal court admission(s), date(s) of admission, and bar ID number(s): 

(3) CERTIFICATION OF DISCIPLINARY ACTIONS: 

(a)	 ☐ I am not now, nor have I ever been subject to any disciplinary action by any 

state or federal bar association; or 

(b)	 ☐ I am now or have been subject to disciplinary action from a state or federal bar 

association. (See attached letter of explanation.) 

(4) CERTIFICATION OF PROFESSIONAL LIABILITY INSURANCE: 

I have professional liability insurance, or financial responsibility equivalent to liability 

insurance, that will apply and remain in force for the duration of the case, including any 

appeal proceedings. 

(5) REPRESENTATION STATEMENT: 

I am representing the following party(s) in this case: 

U.S. District Court–Oregon	 Application for Special Admission - Pro Hac Vice 

Revised March 1, 2014	 Page 2 of 3 

New York, 5/7/2008, NY State Bar No. 4546966 Southern District of New York, 7/21/2009, Bar No. CC0920 ✔

Memory Integrity LLC

Case 3:15-cv-00262-SI Document 204 Filed 04/05/16 Page 2 of 3
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

(6) CM/ECF REGISTRATION: 

Concurrent with approval of this pro hac vice application, I acknowledge that I will 

become a registered user of the Court’s Case Management/Electronic Case File system. 

(See the Court's website at ord.uscourts.gov), and I consent to electronic service pursuant 

to Fed. R. Civ. P 5(b)(2)(E) and the Local Rules of the District of Oregon. 

DATED this day of , 

(Signature of Pro Hac Counsel) 

(Typed Name) 

CERTIFICATION OF ASSOCIATED LOCAL COUNSEL: 

I certify that I am a member in good standing of the bar of this Court, that I have read and understand the 

requirements of LR 83-3, and that I will serve as designated local counsel in this particular case. 

DATED this day of , 

(Signature of Local Counsel) 

Name: 

(Last Name) 

Oregon State Bar Number: 

Firm or Business Affiliation: 

(First Name) (MI) (Suffix) 

Mailing Address: 

City: 

Phone Number: 

State: 

Business E-mail Address: 

Zip: 

COURT ACTION
 

☐ Application approved subject to payment of fees. 

☐ Application denied. 

DATED this day of , 

Judge 

U.S. District Court–Oregon Application for Special Admission - Pro Hac Vice 

Revised March 1, 2014 Page 3 of 3 

4th April 2016 Caryn L. Cross 4th April 2016 Mansfield John 055390 Mansfield Law Portland 971-271-8615 121 SW Morrison Avenue, Suite 400 OR 97204 john@mansfieldlaw.net

Case 3:15-cv-00262-SI Document 204 Filed 04/05/16 Page 3 of 3