REGISTRATION FOR FELONY/MISDEMEANOR PANEL Please Print

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LAW OFFICE OF THE HAMILTON COUNTY PUBLIC DEFENDER Wm. Howard Taft Law Center, 2 nd Flo, 230 East Ninth Street, Cincinnati, OH 45202 Phone: 513-946-3700 Fax: 513-946-3707 REGISTRATION FOR FELONY/MISDEMEANOR PANEL Please Print Name: Supreme Court No. Year Admitted Mailing Address: Office Address: Contacts: Office: Fax: Cell: Email: Home: I hereby agree to notify the Law Office of the Public Defender in writing of any change in my contact infmation, liability insurance, / in my personal professional status that would affect my qualifications to serve as appointed counsel. I underst that my participation as a panel attney is at the discretion of the Public Defender. My participation may be terminated at any time. Any misrepresentation undisclosed change to the following infmation may result in my immediate removal. I hereby agree that pursuant to Regulation III (5) Insurance Compliance, that while accepting any appointed counsel assignments in Common Pleas Court Municipal Court that I will retain maintain malpractice insurance of at least $100,000 per occurrence $300,000 aggregate. Further, I agree to provide a copy of Insurance Declaration page to the Office each every year. My current malpractice insurance carrier is: Carrier Policy No.: I have practiced criminal law in Hamilton County f years f a total of years. During the course of my legal career, I obtained the following experience in: EXPERIENCE Please check all that apply. CAPITAL CASES (1) Lead Trial Counsel (2) Trial Co-Counsel 1

Lead Trial Counsel ( ) At least five years criminal litigation experience ( ) Experience as lead counsel f the defense in jury trial of at least one capital case OR experience as co-counsel f the defense in jury trial of at least two capital cases ( ) Within 10 years preceding appointment, I have experience as lead counsel in jury trial of at least one murder aggravated murder case OR within five years preceding appointment, experience as lead council in three aggravated first second degree felony jury trials ( ) Must meet qualifications of Supreme Court Rules f Appointment of Counsel in Capital Cases (fmerly Rule 20) ( ) Must appear on list of attneys qualified to accept appointments in capital cases promulgated by the Commission on Appointment of Counsel in Capital Cases (fmerly Rule 20 Commission) ( ) Must have a waiver of pre-qualification issued by the Commission on Appointment of Counsel in Capital Cases (fmerly the Rule 20 Commission) Trial Co-Counsel ( ) At least three years of criminal litigation experience ( ) Within 10 years preceding appointment, I have experience as co-counsel in one murder aggravated murder jury trial OR within five years preceding appointment, experience as lead counsel in one first second degree felony trial OR within five years preceding appointment, experience as lead co-counsel in at least two felony jury civil trials ( ) Must meet qualifications of Supreme Court Rules f the Appointment of Counsel in Capital Cases (fmerly Rule 20) ( ) Must appear on list of attneys qualified to accept appointments in capital cases promulgated by the Commission on Appointment of Counsel in Capital Cases (fmerly the Rule 20 Commission) ( ) Must have a waiver of pre-qualification issued by the Commission on Appointment of Counsel in Capital Cases (fmerly Rule 20 Commission) Please list the name(s) case number(s) f the most recent death penalty case the 5 most recent felony cases where you served as counsel: 2

Further, I have experience in the following areas: (2) Where the defendant is charged with murder aggravated murder without specifications any felony that carries potential sentence of life imprisonment, I possess: (Please check all that apply) ( ) At least five years experience in criminal law ( ) Within 10 years preceding appointment, experience as lead trial counsel in five felony jury trials, at least three of which involved felony charges of the 1 st 2 nd degree OR as lead counsel in three jury trials, at least one of which was a 3 rd degree felony as co-counsel in five additional jury trials, at least three of which are 1 st 2 nd degree felonies ( ) Within two years pri to appointment, minimum 12 hours CLE in criminal practice procedure Please list the name(s) case number(s) f the most recent jury trial the 5 most recent cases where you served as counsel: (3) Where the defendant is charged with a felony of the first degree second degree, other than murder aggravated murder, I possess: (Please check all that apply) ( ) At least three years experience in criminal law ( ) Within 10 years preceding appointment, experience as lead trial counsel in two criminal jury trials, at least one of which involved felony charges OR as lead counsel in one felony jury trial as co-counsel in two additional jury trials ( ) Within two years pri to appointment, minimum 12 hours CLE in criminal practice procedure Please list the name(s) case number(s) f the most recent jury trial the 5 most recent cases where you served as counsel: (4) Where the defendant is charged with a felony of the third degree, I possess: (Please check all that apply) ( ) At least one-year experience in criminal law ( ) Within six years preceding appointment, experience as lead trial counsel in at least one criminal jury trial OR as co-counsel in at least two jury trials ( ) Within two years of appointment, minimum 12 hours CLE in criminal practice procedure 3

Please list the name(s) case number(s) f the most recent jury trial the 5 most recent cases where you served as counsel: (5) Where the defendant is charged with a felony of the fourth fifth degree, I possess: (Please check all that apply) ( ) At least one-year experience as a criminal attney ( ) Pri experience as trial counsel co-counsel in at least one jury trial ( ) Pri completion of a training program on criminal practice procedure which is certified f continuing legal education credit by the Ohio Supreme court commission on continuing legal education approved f purposes of this section by the Ohio Public Defender, ( ) Pri successful completion of a clinical legal education program focusing on criminal defense. ( ) Within two years pri to appointment, minimum 12 hours CLE in criminal practice procedure Please list the name(s) case number(s) f the most recent jury trial the 5 most recent cases where you served as counsel program(s) attended over the last two years: (6) Where the defendant is charged with a Felony OVI, I possess: (Please check all that apply) ( ) At least one-year experience in criminal law ( ) Completed at least six hours of continuing legal education, certified by the Ohio Supreme Court Commission on continuing legal education, focused OVI practice procedure, within the last 2 years 4

(7) Where the defendant is charged with a misdemean, I certify that I have: (Please check all that apply) ( ) Completed the minimum of six hours of continuing legal education, certified by the Ohio Supreme Court Commission on continuing legal education, in criminal practice procedure, within the last 2 years. ( ) Pri completion of a New Lawyers Training program including topics on criminal practice procedure which is certified f continuing legal education credit by the Ohio Supreme Court commission on continuing legal education ( ) Pri successful completion of a clinical education program focusing on criminal defense. ( ) One Year experience as an attney. Where the defendant is charged with a Misdemean OVI ( ) Completed at least six hours of continuing legal education, certified by the Ohio Supreme Court Commission on continuing legal education, focused OVI practice procedure, within the last 2 years Please list the name(s) case number(s) f the 5 most recent cases where you served as counsel program(s) attended over the last two years: (8) The Law Office of the Hamilton County Public Defender maintains a misdemean rotation panel f attneys who are willing to accept (1) cases that are conflicts (2) cases that require the appointment of attneys in Room A when the volume on the docket exceeds the number of cases our staff can represent * ( ) I ask to be placed on the Misdemean Panel accepting assignments f the conflict cases. ( ) I ask to be placed on the Misdemean Panel accepting assignments f overflow cases in Room A as needed. ( ) I do not wish to be placed on the Misdemean Panel. *Assignments in Room A are on an on-call basis may only be made the mning of the appointment with a few hours notice. Based upon the fegoing, I believe I am qualified should be categized f the following categies: ( ) Aggravated Murder with Specifications ( ) Lead Counsel ( ) Co-counsel ( ) Felonies: 1-2 ( ) Felonies 3 ( ) Felonies 4-5 ( ) Other Homicides ( ) Misdemeans 5

I would like to participate in the menting program either as a ment mentee. (check one) I underst agree that if I am assigned a case wherein the Gr Jury returns an indictment raising the level of the case to a status exceeding my qualifications, I will rept said fact to the Law Office of the Public Defender request assistance. Please check: I agree I underst that vouchers are to be submitted 30 days of case termination that each voucher must be accompanied by an executed affidavit of indigency in der to receive payment. Failure to submit the voucher in timely fashion will result in a 50% reduction in the fee. Please check: I underst I underst agree that once assigned a client charged with a felony, I shall remain counsel f that client on the felony(s) any related misdemeans. Should the gr jury return an indictment reducing the felony(s) charge(s) to misdemean(s) I shall continue my representation. Please check: I agree I am/have been the subject of an ethical grievance/disciplinary/contempt proceeding in connection to my professional license. Please check: True False. If true, please attach a detailed explanation of the proceedings outcome. I agree to make myself available to have my picture taken to be maintained in an inter-office directy of panel contract attneys. I agree. I have been provided a copy have read the Stards, Guidelines, Regulations of the Law Office of the Hamilton County Public Defender by my signature below do hereby agree to adhere to same. I have read underst the Attney Qualifications established f appointed counsel as set out O.A.C. 120-1-10 agree that I am in compliance with the training experience listed there in. Attached to this REGISTRATION, I am submitting the required documentation (see below) Copy of letterhead/lease verifying location of law office Copy of Continuing Legal Education (CLE) transcript indicating hours completed Copy of Insurance Policy Declarations page verifying amount nature of professional liability insurance. Copy of Attney Registration Card, front back, verifying current registration f active status with the Supreme Court of Ohio. Name (please print) (Signature) (Date) (Approved) (Date Qualified f: 6