Fill - Free fillable Judicial Office Candidates Application-August 2016 0 APPLICATION FOR CANDIDATES FOR JUDICIAL OFFICE PDF form

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APPLICATION FOR CANDIDATES FOR SUPERIOR COURT JUDGE

Date of Application: ____________________________________________________________

Position applied for: ____________________________________________________________

NOTE TO APPLICANT #1: Please submit ONE cover page that includes your Social Security

Number, for the purpose of performing a criminal background check.

NOTE TO APPLICANT #2: Please include a current photograph with each copy of the

application you submit.

GENERAL

1. Name: _________________________________________________________________

2. Mailing address: _________________________________________________________

Business address: ________________________________________________________

Email address: __________________________________________________________

3. Date of Birth: ___________________________________________________________

4. Town of Residence: ______________________________________________________

5. Telephone Nos. Home: ___________ Business: ____________ Cell:_____________

6. Years in which resided in State of Vermont: __________________________________

EDUCATION

7. List colleges and law schools, dates attended, and degrees or credits received:

______________________________________________________________________________

_____________________________________________________________________________

8. Academic honors at the college or law school level, if any:

______________________________________________________________________________

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9. If you clerked for admission to the bar instead of attending law school, please state

the dates and for whom you clerked.

______________________________________________________________________________

PROFESSIONAL ADMISSIONS

10a. List all courts (including state bar admissions) and administrative bodies having special

admission requirements in which you are presently admitted or have previously been

admitted to practice, giving the date of admission in each case.

___________________________________________ Date of Admission: _________________

10b. Has your license to practice in any jurisdiction been suspended, revoked, or limited at

any time. If so, please provide the date(s) and circumstances that led to such action.

______________________________________________________________________________

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EMPLOYMENT HISTORY

11. State the names, addresses, dates and positions held for all legal jobs you have had,

including public interest or private law firms with which you have been associated in

practice, government agencies, corporations, law schools, colleges, universities, or

other private organizations by which you have been employed, and periods you have

practiced as a sole practitioner, including any occupations, business, or professions

pursued since being admitted to the bar.

______________________________________________________________________________

12. Please state the names, addresses, dates and positions held for any other full time

employment since college graduation.

______________________________________________________________________________

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LEGAL EMPLOYMENT AND EXPERIENCE

13a. Describe the general nature of your current practice, or legally related employment,

including any legal specialties which you possess; additionally, if your practice is

substantially different now than previously, please give details of your prior practice.

______________________________________________________________________________

13b. Please describe your professional experience in each of the following legal arenas:

family, civil, criminal, probate, juvenile, municipal, environmental or other.

______________________________________________________________________________

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14. During the past ten years what percentage of your practice has involved litigation,

including motions, hearings, appellate arguments, administrative hearings, trials, and

other contested hearings?

______________________________________________________________________________

15. During the past ten years what percentage of your litigation practice has involved

each of the following:

a. family matters ______________

b. juvenile matters _____________

c. civil matters ________________

d. criminal matters _____________

e. probate ____________________

f. administrative ______________

g. municipal __________________

h. environmental ______________

i. other ______________________

16.

A. Estimate how many contested cases you have tried to conclusion before the following

decision makers over the past five years:

a. a jury ______________________

b. a judge _____________________

c. a hearing officer, board, commission or administrative law judge _________

B. Estimate how many cases you have begun, but not concluded, before the following

decision makers over the past five years:

a. a jury _____________________

b. a judge ____________________

c. a hearing officer, board, commission or administrative law judge _________

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C. In the space below, describe your specific responsibilities in the trials noted in 16A and

16B.

______________________________________________________________________________

17.

A. Estimate the percentage of your total court time spent in each of the above courts

over the last ten years.

a. criminal _______________________

b. family _________________________

c. civil ___________________________

d. probate ________________________

e. federal trial _____________________

f. federal appellate ________________

g. Vermont Supreme Court __________

h. administrative body ______________

i. environmental court ______________

j. other court ______________________

18. Please describe your professional experience in each of the following areas:

a. academics, including teaching, presentations, seminars

______________________________________________________________________________

b. management, including business, law firm, human relations, or other

______________________________________________________________________________

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c. mediation, arbitration, or other dispute resolution

______________________________________________________________________________

d. writing, including articles, journals, books, etc.

______________________________________________________________________________

JUDICIAL EXPERIENCE

19. Have you ever held judicial office? If so, please state your position, the name of the

court(s) and dates of your service.

______________________________________________________________________________

20. Have you ever served as an Acting Judge or Acting Magistrate in the Vermont court

system? If so, please state the courts to which you have been assigned, approximate

dates and the approximate number of assignments you have had.

______________________________________________________________________________

21. Have you ever served as an arbitrator, hearing officer, administrative law judge, or

other administrative decision maker? If so, please describe the service and the

approximate number of assignments you have had.

______________________________________________________________________________

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22. Please state any quasi-judicial boards or commissions on which you have served,

including the name(s) of the agency(ies) for which you served, the position(s) held, the

issues under your jurisdiction, and the dates of such service.

______________________________________________________________________________

23. Calculating all of your judicial or quasi-judicial experience, approximately how many

times have you:

a. prepared a written decision on a contested matter_______________________

b. issued an oral decision on a contested matter ___________________________

c. handled motions or other contested proceedings_________________________

d. conducted an evidentiary hearing or proceeding_________________________

PUBLICATIONS

24. If you have published any books or articles not identified in response to previous

questions, please list them, giving titles, citations, and dates.

______________________________________________________________________________

PROFESSIONAL, CIVIL AND PUBLIC SERVICE

25. If you have experience as a member of any administrative, legislative, judicial, or

regulatory boards, commissions, study committees, or agencies, or any private,

corporate or non-profit boards, please list them, giving names and dates served.

______________________________________________________________________________

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26. If you have served as an appointed or elected official in any local, county, state, or

federal government position, please provide details and dates.

______________________________________________________________________________

27. Please list all Bar associations and professional societies of which you are a member,

give the titles and dates of any office which you may have held in such groups, and

identify committees in which you were active.

______________________________________________________________________________

28. List any honors, prizes or awards you have received, including the name of the award,

the organization granting it, and the date of the award.

______________________________________________________________________________

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29. Please list all other non-profit, community, service, or such other organizations, of

which you have been a board member during the past ten years, including the titles

and dates of any offices which you have held in each such organization, or any

significant volunteer experience.

______________________________________________________________________________

BUSINESS INVOLVEMENT

30. If you are now an officer, director, or otherwise engaged in the management of any

business enterprise, (including a law firm), state the name of such enterprise, the

nature of the business, the nature of your duties, and whether you intend to resign

such position immediately upon your appointment to judicial office.

______________________________________________________________________________

31. State whether during the past five years you have received any fees or compensation

of any kind, with a value in excess of $500.00, other than for legal services rendered,

from any business enterprise, institution, or association of any kind. If so, identify the

source of such compensation, the nature of the business enterprise, institution,

organization or association involved, and the dates such compensation was paid.

______________________________________________________________________________

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32. List sources, amounts and dates of all anticipated receipts from deferred income

arrangements, stock options, uncompleted contracts and other future benefits which

you expect to derive from legal or previous business relationships, professional

services, firm membership, former employers, clients or customers. Please describe

the arrangements you have made to be compensated in the future for any financial,

legal, or business interest if you are appointed to judicial office.

______________________________________________________________________________

33. Do you have any plans, commitments, or agreements to pursue outside employment,

with or without compensation, during your service to the Court? If so, please explain.

______________________________________________________________________________

CONFLICTS

34. Do you have any significant personal relationship(s) which in your view might present

conflicts of interest in the position you are seeking? If so, please explain.

______________________________________________________________________________

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35. Explain how you will resolve any potential conflict of interest, including the procedure

you will follow in determining these areas of concern. Identify the categories of

litigation and financial arrangements that are likely to present potential conflicts of

interest during your initial service if you are appointed to the position for which you

are applying.

______________________________________________________________________________

FINANCIAL

36. List sources and amounts of all income received by you during the calendar year

preceding your application and for the current calendar year, including all salaries,

fees, dividends, interest, gifts, rents, royalties, patents, honoraria, and other items

exceeding $500.00 in value. You need not identify each individual client who may have

paid you a fee.

______________________________________________________________________________

37. Provide complete a current financial statement using the attached sheet on page 19.

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MISCELLANEOUS

38. Have you ever been arrested, charged, held, or convicted by federal, state or other

law enforcement authorities for a violation of any federal law, state law, or county or

municipal law, regulation or ordinance? If so, please give details. Do not include traffic

violations for which a fine of $150 or less was imposed, unless it also included a jail

sentence. NOTE TO APPLICANT: The Judicial Nominating Board conducts a criminal

background check on every applicant.

______________________________________________________________________________

39. Have you ever been sued? If so, please provide details about the case and its

disposition.

______________________________________________________________________________

40. Have you or your professional liability insurance carrier ever settled a claim against

you for professional malpractice? If so, please give particulars, including the amounts

paid.

______________________________________________________________________________

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41. Have you ever been disciplined for a breach of ethics or unprofessional conduct by any

court, administrative agency, bar association, professional group, or Professional

Conduct or Responsibility Board in any jurisdiction? If so, please provide details.

______________________________________________________________________________

42. Were all your taxes (federal, state and local) current (i.e., filed and paid) as of the date

of this application?

______________________________________________________________________________

43. Has a tax lien or other collection procedure (including receipt of balance due notices)

ever been instituted against you by any federal, state, or local tax authority? If so,

please explain and describe the outcome.

______________________________________________________________________________

44. Have you ever been the subject of any audit, investigation, or inquiry for either

federal, state or local taxes? If so, give full details.

______________________________________________________________________________

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45. Have you ever declared bankruptcy? If so, give details.

______________________________________________________________________________

JUDICIAL OFFICE QUESTIONS

46. Why do you want to hold the judicial position for which you are applying?

_________________________________________________________________________

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47. Please describe a legal case or experience that has a special significance in shaping you

as a lawyer, as a person, or both, and why.

_________________________________________________________________________

48. Please describe a personal experience that you believe will influence your ability to

serve as a successful judge and why?

_________________________________________________________________________

49. Please describe how you plan to address the change in lifestyle that comes with

being appointed to a judicial position. This includes social changes, as well as

logistical changes.

_________________________________________________________________________

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50. Please attach a representative writing sample appropriate for the position for which you

are applying. (Maximum of 10 pages.)

50a. In the space below, please explain why you selected this writing sample.

_________________________________________________________________________

51. List the names, addresses, e-mail addresses, and phone numbers of at least four, but no

more than six persons, of whom inquiry may be made by the Judicial Nominating Board.

Please include at least two professional adversaries. Please describe how each named

reference knows you.

Please be advised that Judicial Nominating Board rules permit Board members to

contact non-references for additional information about applicants.

_________________________________________________________________________

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_________________________________________________________________________

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FINANCIAL STATEMENT

NET WORTH

Please complete this financial statement, which should include all assets and liabilities of

yours, your spouse, and other immediate members of your household.

ASSETS LIABILITIES

Cash on hand and in banks $___________ Real estate mortgages $__________

Securities $___________ Credit cards or personal loans $__________

Real estate owned $___________ Other Secured notes $__________

Accounts and notes receivable $___________ Other unsecured notes $__________

Autos & other tangible property $___________ Accounts and bills due $__________

Other assets $___________ Unpaid taxes $__________

Other debts $__________

TOTAL ASSETS $___________ TOTAL LIABILITIES $__________

TOTAL NET WORTH: $___________

Please explain in the space below any non-real estate liabilities exceeding $10,000.

_________________________________________________________________________

0.00

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AFFIDAVIT

_____________________________________, being first duly sworn, deposes and

says that all of the information I have provided in this Application is true.

_______________________________

Signature of Candidate

STATE OF VERMONT )

________________ COUNTY, SS)

At _____________, in said County, _____________________________ personally

appeared and subscribed and swore to the truth of the above before me this _____ day of

____________, 201__.

_______________________________

Notary Public

My commission expires: ___________

WAIVER

I hereby waive my right to privacy as it relates to the Judicial Nominating Board of

any information I have provided herein, including the right of the Board to freely

communicate with any names listed on my reference sheet with the understanding that

any information will be held in confidence by the Board. I hereby authorize the custodian

of any records or information to permit the examination or receipt of such information,

whether written or oral, by the Judicial Nominating Board. I also understand and agree

that if my name is forwarded to the Governor’s office it will be accompanied by this full

application.

Dated: ____________________ _______________________________

Signature of Candidate

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