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

Revised March 28, 2016 Page 1 of 3 

UNITED STATES DISTRICT COURT

DISTRICT OF OREGON

Plaintiff(s),

v. 

______________________________________ 

Defendant(s).

Civil Case No. ____________ 

APPLICATION FOR SPECIAL 

ADMISSION – PRO HAC VICE 

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) (MI) (Suffix)

Firm or Business Affiliation: 

Mailing Address:

City: State: Zip: 

Phone Number: Fax Number: 

Business E-mail Address: 

_________________________________ USA

AMMON BUNDY, et al.

MARCUS R. MUMFORD

MUMFORD, MARCUS R.

405 S. Main Street, Ste. 975

Salt Lake City UT 84111

(801) 428-2000 (801) 983-6405

mrm@mumfordpc.com

Marcus R. Mumford, P.C.

3:16-cr-0051-BR

Case 3:16-cr-00051-BR Document 655 Filed 06/07/16 Page 1 of 3
U.S. District Court–Oregon Application for Special Admission - Pro Hac Vice

Revised March 28, 2016 Page 2 of 3 

(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:

Per LR 83-3(a)(3), I have professional liability insurance, or financial responsibility

equivalent to liability insurance, that meets the insurance requirements of the Oregon

State Bar for attorneys practicing in this District, and 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:

(2) BAR ADMISSIONS INFORMATION:

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

New York (4004008) – admitted 11/14/2001; Idaho (6585) - admitted

1/6/2003; California (243270) - admitted 6/6/2006; Utah (12737) -

admitted 10/20/2009

USCA 6th Circuit – 12/10/2001; USCA 9th Circuit - 8/15/2006; USCA 10th

Circuit - 8/9/2010; USDC for SDNY -2/1/2005; USDC for EDNY -

2/1/2005; USDC for C.D. Cal.- 6/26/2006; USDC for N.D. Cal. - 6/4/2007;

USDC for D. Utah - 10/20/2009; USDC for D. Idaho 9/14/2010

Ammon Bundy

Case 3:16-cr-00051-BR Document 655 Filed 06/07/16 Page 2 of 3
U.S. District Court–Oregon Application for Special Admission - Pro Hac Vice

Revised March 28, 2016 Page 3 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) (First Name) (MI) (Suffix) 

Oregon State Bar Number: 

Firm or Business Affiliation: 

Mailing Address: 

City: State: Zip: 

Phone Number: Business E-mail Address: 

COURT ACTION

☐ Application approved subject to payment of fees.

☐ Application denied.

DATED this day of , 

Judge

7th June 2016

Marcus R. Mumford

Case 3:16-cr-00051-BR Document 655 Filed 06/07/16 Page 3 of 3