Board of Overseers of the Bar

Board of Overseers of the Bar

Contact Information Change Form
Bar Number
Attorney Name

PrefixFirst NameMiddle NameLast Name
Section I. Name Change

PrefixFirst NameMiddle NameLast NameSuffix
Name change requests must be accompanied by a copy of the name change order, I.e. marriage license, divorce decree, court order, etc.

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Section II. Contact Information Change
Office/Firm Name
Office/Firm Name
Street Address

P O Box

CityState

Zip CodeCountry
Email
Email Address
Phone

Area CodePhone Number
Phone 2

Area CodePhone Number
Fax

Area CodeFax Number
Residence Address

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
Email Address
Phone

Area CodePhone Number
Fax

Area CodeFax Number
Section III. Preferred mailing address:

ResidenceOffice
IOLTA Update

You only need to complete this section if there are changes to your IOLTA accounts.
I report that:

Pursuant to Maine Bar Rule 6(b), I set forth below a current listing of all Maine bank account number(s) and financial institution(s) of any pooled trust account(s) for me or my firm. By the signature below, I direct the financial institution(s) listed below to automatically and without further documentation convert all eligible trust accounts, which are not yet in the IOLTA program, to interest bearing accounts with all interest payable to the Maine Justice Foundation. I authorize the financial institutions to disclose information relating to the existence of these accounts.Because I handle no client funds, I am exempt from the provisions of Maine Rules of Professional Conduct 1.15 and Maine Bar Rule (6)(b).Because I practice outside the State of Maine and handle no Maine client funds, I am exempt from the provisions of Maine Rules of Professional Conduct 1.15 and Maine Bar Rule (6)(a)(2).
Account #1
Name of Financial Institution and Branch
Name on Account
Account Number
Account #2
Name of Financial Institution and Branch
Name on Account
Account Number
Account #3
Name of Financial Institution and Branch
Name on Account
Account Number
If you have additional accounts, provide with a list for the Board's records.

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I certify that the information I am providing on this form is true and accurate.*
Attorney Signature (Required)
Board of Overseers of the Bar . P.O. Box 527. Augusta, ME 04322-0527

P. (207) 623-1121 . F. (207) 623-4175
Should be Empty:

Board of Overseers of the Bar

IOLTA Update