19 th Judicial Circuit Court Appointed Attorney Application and Preference Form

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1 19 th Judicial Circuit Curt Appinted Attrney Applicatin and Preference Frm Please prvide the fllwing infrmatin as a part f the applicatin and verificatin prcess fr the General Registry f Curt Appinted Attrneys. This applicatin must be cmpleted in its entirety and submitted electrnically if yu wish t be cnsidered fr appintment as a curt appinted attrney in the Nineteenth Unless applying fr the categries f appeals r death penalty cases, it is required that yu have an ffice in the 19 th Circuit. General Registry: Sectin 27.40, Flrida Statutes, requires the chief judge t cmpile a registry f qualified attrneys available fr appintment t represent persns in thse cases where the Office f Criminal Cnflict and Civil Reginal Cunsel is unable t prvide representatin due t cnflict f interest. The registry is t include qualified and experienced attrneys cmpiled by cunty and by categry (type) f cases. Applicant Infrmatin Name: Flrida Bar Number: (As it appears n yur FL Bar Membership) Business Address: (Street Address) (City) (State) (Zip Cde) Business # ( ) Cell # ( ) Fax # ( ) Address: Sec (3)(d), Fla. Stats., as amended, requires the chief judge t reprt the race, gender and natinal rigin f all attrneys listed n and appinted frm t the limited registry. Please cmplete the fllwing: Race: (mark X in apprpriate space) ( ) Hispanic r Latin a persn f Cuban, Mexican, Puert Rican, Suth r Central American, r ther Spanish culture r rigin regardless f race. ( ) White (Nt Hispanic r Latin) a persn having rigins in any f the riginal peples f Eurpe, the Middle East r Nrth Africa ( ) Black r African American (Nt Hispanic r Latin) a persn having rigins in any f the black racial grups f Africa ( ) Native Hawaiian r Other Pacific Islander (Nt Hispanic r Latin) a persn having rigins in any f the peples f Hawaii, Guam, Sama r ther Pacific Islands. ( ) Asian (Nt Hispanic r Latin) a persn having rigins in any f the riginal peples f the Far East, Sutheast Asia r the Indian Subcntinent, including Cambdia, China, India, Japan, Krea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.

2 ( ) American Indian r Alaska Native (Nt Hispanic r Latin) a persn having rigins in any f the riginal peples f Nrth, Central and Suth America, and wh maintain tribal affiliatin r cmmunity attachment. ( ) Tw r Mre Races (Nt Hispanic r Latin) all persns wh identify with mre than ne f the abve five nn-hispanic r Latin races. Natinal Origin r Ancestry: (list all cuntries) Gender: ( ) Male ( ) Female Please check the fllwing that apply: I am a member in gd standing with the Flrida Bar. I have familiarized myself with the Administrative Orders relating t Curt Appinted Attrneys. I am familiar with and experienced in the utilizatin f expert witnesses and evidence, including but nt limited t psychiatric and frensic evidence. I agree t cmply with the Administrative Order f the Curts requirements fr billing. I will nt slicit cmpensatin frm the defendant r ther client that I am appinted t represent. I will ntify Chief Judge Steven J. Levin f any frmal cmplaint filed by The Flrida Bar against me; any nn-cnfidential cnsent agreements entered int between myself and The Flrida Bar; any claim f ineffective assistance f cunsel that has been set fr a hearing befre a judge r magistrate. Failure t cmply with these prfessinal requirements may result in the attrney being remved frm all curt-appinted lists fr a minimum f three years. Nineteenth Judicial Circuit Curt Appinted Attrney Case Classificatin Preference Frm Place an "X" in the apprpriate blck(s) Cntract Name St. Lucie Martin Indian River Okeechbee Nn-Capital 1st Degree Felnies & Capital Sexual Battery 2 nd and 3 rd Degree Felnies Misdemeanr Cases Juvenile Delinquency Cases Criminal, Juvenile Delinquency & Jimmy Ryce Appeals Jimmy Ryce Trials

3 Capital Death Penalty Cases lead-cunsel Capital Death Penalty Cases c-cunsel Capital Death Penalty Appeals Dependency Cases - Attrney fr Parent Dependency Cases - Attrney fr Child Dependency Appeals Standard Guardianship Emergency Guardianship Guardianship Appeals Felny - V.O.P. Misdemeanr V.O.P. CINS/FINS Cases Standards Please verify and check the fllwing as applicable: Fill in nly the verificatin infrmatin fr the lists fr which yu are applying. Checking a bx is yur certificatin that yu meet that specific requirement fr the particular curt-appinted cunsel standard. Capital Death Penalty Cases (Lead Cunsel): I have been a member in gd standing with The Flrida Bar fr the previus five years. I am an experienced and active trial practitiner with at least five years f litigatin experience in the field f criminal law. I have served as lead cunsel in n fewer than nine state r federal jury trials f serius and cmplex cases which were tried t cmpletin, as well as prir experience as lead defense cunsel r c-cunsel in at least tw state r federal cases tried t cmpletin in which the death penalty was sught. I have served as lead cunsel and tried t cmpletin at least three jury trials in which the charge was murder; r alternatively, I have tried t cmpletin at least ne murder trial and an additinal five felny jury trials. I am familiar with the practice and prcedure f the criminal curts f the Nineteenth

4 I have demnstrated the necessary prficiency and cmmitment that exemplify the quality f representatin apprpriate t capital cases, including but nt limited t the investigatin and presentatin f evidence in mitigatin f the death penalty. I have attended within the last twelve mnths a cntinuing legal educatin prgram f at least twelve hurs duratin devted specifically t the defense f capital cases. Capital Death Penalty Cases (C-Cunsel): I have been a member in gd standing with The Flrida Bar fr the previus five years. I am an experienced and active trial practitiner with at least three years f litigatin experience in the field f criminal law. I have served as lead cunsel r c-cunsel in n fewer than three state r federal jury trials f serius and cmplex cases which were tried t cmpletin. I have tried t cmpletin at least tw trials in which the charge was murder; r alternatively, I have tried t cmpletin at least ne murder trial and an additinal felny jury trial I am familiar with the practice and prcedure f the criminal curts f the Nineteenth I have demnstrated the necessary prficiency and cmmitment that exemplify the quality f representatin apprpriate t capital cases. I have attended within the last twelve mnths a cntinuing legal educatin prgram f at least twelve hurs duratin devted specifically t the defense f capital cases. Capital Death Penalty Appeals: I have been a member in gd standing with The Flrida Bar fr the previus five years. I am an experienced and active trial r appellate practitiner with at least five years f experience in the field f criminal law. I have prir experience in the appeal f at least ne case where a sentence f death was impsed, as well as prir experience as lead cunsel in the appeal f n fewer than three felny cnvictins in federal r state curt, at least ne f which was an appeal f a murder cnvictin; r alternatively, have prir experience as lead cunsel in the appeal f n fewer than six felny cnvictins in federal r state curt, at least tw f which were appeals f a murder cnvictin. I am familiar with the practice and prcedure f the appellate curts f the State f Flrida. I have demnstrated the necessary prficiency and cmmitment that exemplify the quality f representatin apprpriate t capital cases. I have attended within the last twelve mnths a cntinuing legal educatin prgram f at least twelve hurs duratin devted specifically t the defense f capital cases. Nn-Capital 1 st Degree Felnies & Capital Sexual Battery & Vilatin f Prbatin: I have been a member in gd standing with The Flrida Bar fr the previus five years. I have cmpleted within the last twelve mnths a minimum f ten hurs f CLE apprved by The Flrida Bar and devted t criminal law. I am an experienced and active trial practitiner with n fewer than ten state r federal jury trials as lead r c-cunsel, including five felny jury trials that were tried t cmpletin. I am familiar with the practice and prcedure f the criminal curts in the Nineteenth Secnd and Third Degree Felnies and Vilatin f Prbatin: I have been a member in gd standing with The Flrida Bar fr the previus three years. I have cmpleted within the last twelve mnths a minimum f ten hurs f CLE apprved by The Flrida Bar and devted t criminal law.

5 I am an experienced and active trial practitiner with n fewer than five state r federal jury trials as lead cunsel r c-cunsel, including tw felny jury trials that were tried t cmpletin. I am familiar with the practice and prcedure f the criminal curts in the Nineteenth Misdemeanr and Misdemeanr Vilatin f Prbatin in Cunty Curt: I have been a member in gd standing with The Flrida Bar fr mre than ne year with n disciplinary histry with The Flrida Bar fr the past 3 years. I have cmpleted within the last twelve mnths a minimum f ten hurs f CLE apprved by The Flrida Bar and devted t criminal law. I am an experienced and active trial practitiner with n fewer than three state r federal criminal trials. I am familiar with the practice and prcedure f the criminal curts in the Nineteenth Nn-Capital Felny, Misdemeanr and Jimmy Ryce Appeals: I have been a member in gd standing with The Flrida Bar fr the previus three years. I have cmpleted within the last twelve mnths a minimum f ten hurs f CLE apprved by The Flrida Bar and devted t appellate law. I am an experienced and active practitiner in the field f appellate criminal law and have experience in the appeal f at least five criminal cases, at least tw f which were felnies. I am familiar with the practice and prcedures f the criminal curt in the Nineteenth Jimmy Ryce Trials: I have been a member in gd standing with The Flrida Bar fr the previus five years. I have cmpleted within the last twelve mnths a minimum f ten hurs f CLE apprved by The Flrida Bar and devted t criminal law. I am an experienced and active trial practitiner with n fewer than ten state r federal jury trials, as lead cunsel r c-cunsel, including five jury trials that were tried t cmpletin. I am familiar with the practice and prcedure f the criminal and civil curts in the Nineteenth Circuit. Juvenile Delinquency Trials: I have been a member in gd standing with The Flrida Bar fr at least ne year. I am familiar with practice and prcedure f delinquency prceedings and the Unified Family Curt f the Nineteenth I am an experienced trial practitiner with n fewer than three delinquency dispsitins r three state r federal trials cmpleted t dispsitin. I have cmpleted within the last twelve mnths a minimum f ten hurs f CLE apprved by The Flrida Bar and devted t criminal law. I have cmpleted within the last twelve mnths at least three hurs f CLE apprved by The Flrida Bar devted t delinquency law. This CLE may be part f the ten hurs criminal law CLE required abve. Emergency Guardianship: I have been a member in gd standing f The Flrida Bar fr the previus three years.

6 I am familiar with the practice and prcedure f guardianship prceedings in the Nineteenth I am an experienced trial practitiner wh has represented clients in n fewer than ten (10) guardianship prceedings. I have cmpleted within the last twelve mnths a minimum f three hurs f CLE apprved by The Flrida Bar devted t guardianship law. I certify that I am familiar with statutry and case law fr the fllwing prceedings and certify cmpetency t prvide representatin in the fllwing prceedings: Chapter 415 fr Adult Prtective Services; the Marchman Act; the Baker Act; Chapter 392 fr victims f tuberculsis; Chapter 744 & 765 and Fla. R. Prb Health Care Advance Directives; and Chapter 384 fr victims f sexually transmitted diseases. Standard Guardianship: I have been a member in gd standing f The Flrida Bar fr the previus three years. I am familiar with the practice and prcedure f guardianship prceedings in the Nineteenth I am an experienced trial practitiner wh has represented clients in n fewer than ten (10) guardianship prceedings. I have cmpleted within the last twelve mnths a minimum f three hurs f CLE apprved by The Flrida Bar devted t guardianship law. Guardianship Appeals: I have been a member in gd standing f The Flrida Bar fr the previus three years. I am familiar with the practice and prcedure f guardianship prceedings in the Nineteenth I am an experienced appellate practitiner wh has represented clients in n fewer than five (5) appeals. I have cmpleted within the last twelve mnths a minimum f three hurs f CLE apprved by The Flrida Bar devted t guardianship law. Dependency: I have been a member in gd standing with The Flrida Bar fr the previus three years. I am familiar with the practice and prcedure f dependency prceedings in the Nineteenth Judicial Circuit including the applicatin f the Juvenile Rules f Prcedure and the Family Law Rules f Prcedure. I have cmpleted within the last twelve mnths a minimum f three hurs f CLE apprved by The Flrida Bar devted t dependency law. I have tried at least tw terminatin f parental rights cases r have ne year f dependency experience; r I have bserved at least thirty (30) hurs f hearings, including six shelter hearings, three dependency hearings, and ne TPR hearing. Attrney fr Child: I have been a member in gd standing with The Flrida Bar fr the previus three years. I am familiar with the practice and prcedure f dependency prceedings in the Nineteenth Judicial Circuit including the applicatin f the Juvenile Rules f Prcedure and the Family Law Rules f Prcedure. I have bserved at least 30 hurs f hearings, including six shelter hearings, three dependency hearings, and ne TPR hearing.

7 I have cmpleted within the last twelve mnths a minimum f three hurs f CLE apprved by The Flrida Bar devted t dependency law. I have cmpleted the three-hur training curse fr attrneys fr children ffered by the Guardian Ad Litem prgram. Dependency Appeals: I have been a member in gd standing with The Flrida Bar fr the previus three years. I am familiar with practice and prcedure f dependency prceedings in the Nineteenth I am an experienced appellate trial practitiner with a least three years f experience in dependency r appellate law. I am an experienced and active practitiner in the field f appellate law r have experience in the appeal f at least five cases nt limited t dependency r terminatin f parental rights. I have cmpleted within the last twelve mnths a minimum f three hurs f CLE apprved by The Flrida Bar devted t dependency law. I have been lead cunsel in at least ne cntested dependency trial and ne cntested terminatin f parental rights trial r can demnstrate knwledge thrugh experience in the practice f family law. Case descriptins must reflect the verificatin infrmatin indicated abve. Fr example, if yu must have experience in ten felny trials, cmplete ten case descriptins; if yu must have experience in fifteen guardianship prceedings cmplete ten case descriptins, etc. If yu need mre than 5 case descriptins t cmplete yur applicatin fr each desired list, then yu must cpy and attach additinal frms. In cnfidential juvenile cases, yu may use initials instead f full client names. Yu must ensure that the case descriptins reflect the type and number f prceedings necessary t qualify yu fr appintment. Failure t d s will result in yur applicatin nt being cnsidered by Chief Judge Steven J. Levin. Case Descriptin Darken the apprpriate circle Darken the apprpriate circle Darken the apprpriate circle O Jury Trial Nature f Representatin Type f Prceeding O Bench Trial Lead Cunsel Capital Murder O Other Prceeding C-cunsel Felny Misdemeanr (Explain) Delinquency Dependency Guardianship Jimmy Ryce

8 Case Name: Case Number: Charges (including the dispsitin f case): Case Descriptin Darken the apprpriate circle Darken the apprpriate circle Darken the apprpriate circle O Jury Trial Nature f Representatin Type f Prceeding O Bench Trial Lead Cunsel Capital Murder O Other Prceeding C-cunsel Felny Misdemeanr (Explain) Delinquency Dependency Guardianship Jimmy Ryce Case Name: Case Number: Charges (including the dispsitin f case): Case Descriptin Darken the apprpriate circle Darken the apprpriate circle Darken the apprpriate circle O Jury Trial Nature f Representatin Type f Prceeding O Bench Trial Lead Cunsel Capital Murder O Other Prceeding C-cunsel Felny Misdemeanr (Explain) Delinquency Dependency Guardianship Jimmy Ryce

9 Case Name: Case Number: Charges (including the dispsitin f case): Case Descriptin Darken the apprpriate circle Darken the apprpriate circle Darken the apprpriate circle O Jury Trial Nature f Representatin Type f Prceeding O Bench Trial Lead Cunsel Capital Murder O Other Prceeding C-cunsel Felny Misdemeanr (Explain) Delinquency Dependency Guardianship Jimmy Ryce Case Name: Case Number: Charges (including the dispsitin f case): Case Descriptin Darken the apprpriate circle Darken the apprpriate circle Darken the apprpriate circle O Jury Trial Nature f Representatin Type f Prceeding O Bench Trial Lead Cunsel Capital Murder O Other Prceeding C-cunsel Felny Misdemeanr (Explain) Delinquency Dependency Guardianship Jimmy Ryce Case Name:

10 Case Number: Charges (including the dispsitin f case): Attach the fllwing dcuments fr review. 1 Please cpy and attach additinal frms fr case descriptins as needed. 2 Submit a brief resume. I certify that the answers given herein are true and cmplete. I understand that false r misleading infrmatin given in my applicatin r missin f infrmatin requested will be grunds fr refusal f appintment r dismissal. I understand als, if appinted, I will adhere t the cntract and applicable Administrative Orders within the Nineteenth Signature f Applicant Date Please submit cmpleted applicatin and ther dcuments t: Chief Judge Elizabeth A. Metzger, In Care f: Curt Administratin, Nineteenth Judicial Circuit 250 NW Cuntry Club Dr., Suite 217 Prt St. Lucie, FL Or t:

c) Be a permanent resident of the United States and the State of Florida. (A resident is

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