DCSS eDelivery Form | Lassen Superior Court

Temporary Judge Application
Applicant's Contact Information
Name*

First NameMiddle NameLast Name
Title*

Ms.Mrs.Mr.Dr.No TitleOther
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code
Telephone*
Cell Phone
Email*

Practice and Experience
My law practice in California takes place in the following counties:*
My litigation practice takes place in the following state or federal courts:*
Approximately how many times have you appeared in court in the last 12 months?*
My major area or areas of practice are:*

I represent one side in 90% of the cases, or hold myself out publicly as representing exclusively one side, in the following areas of litigation practice:

	Area or Practice	Side Represented
-
-
-
-

Required questions concerning serving previously as a Temporary Judge:
Have you previously served in this court as a temporary judge?*

YesNo
Have you ever served in other California courts as a temporary judge?*

YesNo
Have you ever been removed by a court as a temporary judge?*

YesNo
You have answered 'Yes' to one or more of the questions above, please describe your prior service, identify the specific courts served, the approximate dates of your service for each court, the numbers and types of matters hears, and the circumstanced of removal, if any. (If you need to provide more information that cannot be entered below, please email information to TJP@lassencourt.ca.gov.)*
Describe your experiences as an Alternative Dispute Resolution ("ADR") neural:*

Additional Information

If applicable, please respond to the following questions. (Send an email to TJP@lassencourt.ca.gov if you need to supply additional information.)
The following facts concerning my background, situation or circumstances may positively or negatively reflect on me or on my suitability for appointment, and should be disclosed to the court:
If applicable
The following limitations may affect my capability to serve as a temporary judge, e.g., physical limitations or subject matter restrictions, and may require accommodations. (Note: you will be completing a separate form providing availability and scheduling constraints.):
If applicable
Please specify any languages other than English you speak well enough to communicate effectively with litigants:
If applicable
Please list any other particular skills, training, interests, areas of expertise, or preferences you believe may assist you in serving as a Settlement Attorney - please be sure to list any other ADR panels on which you serve (whether with this court or another) and any ADR specific training you may have had:
If applicable

Training

Email certificates of completion for all courses attended to TJP@lassencourt.ca.gov
Within the last three years, I have completed or will complete within 30 days the following training that satisfies the requirements of California Rules of Court, CRC 2.812, and CRC 2.813*

3 hours of training on bench conduct, demeanor, decorum, access, fairness, elimination of bias, and adjudicating cases involving self-represented parties.3 hours of training in judicial ethics.5 hours of training in the substantive areas for small claims cases.3 hours of training in the substantive areas for traffic cases.3 hours of training in substantive areas for civil, probate, or family.Other

Confirmation & Submission
I am applying to serve as a:*

Temporary Judge
The following requirements apply to those who wish to serve as a temporary judge:*

In order for my application to be considered, I will submit two letters of reference to the Temporary Judge Administrator (TJP@lassencourt.ca.gov), under separate submission.Pursuant to the Fair Political Practices Commission's (FPPC) Statement of Economic Interest - Form 700, I understand that if I serve more than 30 days in a calendar year I will be required to complete a Form 700 and file it with the FPPC.I declare under penalty of perjury under the laws of the State of California that the foregoing, including statements made in all emails sent to the court regarding this application, is true and correct. I understand that any misstatement or omission of material fact may disqualify me from serving as a temporary judge.
You must check/agree to all of the above requirements, please check all boxes to proceed.
Neither court appointment nor service of an attorney as a temporary judge or a settlement attorney establishes an employment relationship between the court and the attorney. Attorneys are appointed and serve voluntarily as a temporary judge or as a settlement attorney solely at the discretion of the presiding judge. (CRC 2.811)
WAIVER AND AUTHORIZATION FOR RELEASE OF INFORMATION
I have applied to be appointed as a temporary judge in the Superior Court of California, County of Lassen. I hereby authorize the State Bar of California and the attorney-licensing authority in any other state where I am admitted to practice law to release to an authorized representative of the court, information regarding the following matters:
1. whether I am in good standing or am otherwise authorized to practice law as a member of the State Bar of California or as an attorney in any other state where I am admitted to practice law;
2. whether I have a record of discipline with the State Bar of California or with the licensing authority for attorneys in any state where I am admitted to practice law; and
3. whether any disciplinary investigation or proceeding is pending against me by the State Bar of California or by the licensing authority for attorneys in any other state where I am admitted to practice law.
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Temporary Judge Application

Applicant's Contact Information

Professional Qualifications

Required questions regarding disciplinary actions:

Practice and Experience

Required questions concerning serving previously as a Temporary Judge:

Additional Information

Training

Confirmation & Submission

WAIVER AND AUTHORIZATION FOR RELEASE OF INFORMATION