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CRIMINAL HEARING OFFICER HARRIS COUNTY COURTS APPLICATION 2016 Follow the instructions carefully. Please ensure that your responses are legible. You must submit a signed and notarized application to the receptionist for the District and Harris County Courts Administrative Offices located at 1201 Franklin, 7th Floor, by 5:00 p.m. on June 13, 2016. Late applications will not be accepted. If you have any questions about the application or the application process, please call the Administrative Offices at (713) 755-6575 or (713) 755-5394. Required Application Attachments 1. A recent photograph of yourself, no larger than 3 x 5 inches, suitable for scanning. If you do not have a suitable photo, make arrangements with the Administrative Office of the District Courts to have one taken. 2. Your most recent annual CLE report from the State Bar. 3. Any other documents specified in the application. Please also include written explanations if you have ever: a. been sanctioned by the State Bar Grievance Committee. b. been sanctioned for failure to appear before a court. c. been arrested, convicted or placed on deferred adjudication for any offense other than traffic offenses. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.

APPLICATION HARRIS COUNTY HEARING OFFICER 2016 PART A GENERAL INFORMATION CONTACT INFORMATION (Please Print Very Clearly): TITLE (CIRCLE ONE): MR. MS. LAST NAME: LAST NAME IN JIMS: (if different) FIRST NAME: BAR CARD #: SOCIAL SECURITY #: HOME ADDRESS: (not a P.O. Box) OFFICE ADDRESS: HOME PHONE #: CITY: CITY: SPN: OFFICE PHONE#: PAGER #: CELL PHONE #: E-MAIL ADDRESS: (Provide only if you wish to be contacted via e-mail) PROFILE Circle YES or NO. If you circle YES for any of Questions 1-11, attach any applicable court or committee documents, copies of all final orders (or those deferring adjudication), judgments, and, if desired, any written explanations. ZIP: ZIP: Yes No 1. Are you currently in good standing with the State Bar? Yes No 2. Have you ever been arrested or charged with an offense other than a class C traffic offense? Yes No 3. Do you have a pending appeal of any State Bar sanction? Yes No 4. Has the State Bar Grievance Committee ever sanctioned you? Yes No 5. Have you ever been sanctioned for failure to appear before a court? Yes No 6. Have you ever admitted, in connection with an official proceeding, to having provided ineffective assistance of counsel? 2 Application for Harris County Criminal Hearing Officer

Yes No 7. Have you ever been convicted or placed on deferred adjudication for any offense other than a traffic offense? Yes No 8. Have you, to your knowledge, ever been under federal, state, or local investigation for possible violation of a criminal statute? If so, give particulars? Yes No 9. Has a tax lien or other collection procedure ever been instituted against you by federal, state, or local authorities? If so, give particulars. Yes No 10. Have you ever been sued by a client? If so, give particulars. Yes No 11. Have you ever been a party or otherwise involved in any other proceedings? If so, give the particulars. BACKGROUND 12. Where and when did you graduate from law school? Top 1/2 Bottom 1/2 13. Where did you graduate in your law school class? 14. List all courts in which you have been admitted to practice, with dates of admission. Yes No 15. Are you board certified by the Texas Board of Legal Specialization? 16. If yes, in what area(s)? 17. How many years have you been in practice? 18. How many hours of continuing legal education did you average the last three years? Attach your latest annual State Bar of Texas CLE report. 19. How many open files are in your current caseload? 20. What percentage of your current practice is in criminal law? 21. Please list the Harris County judges before whom you routinely appear. (Provide the judge s name, not the court number.) EXPERIENCE (FOR QUESTIONS 22-24 ATTACH ADDITIONAL PAGES IF NECESSARY) 22. Briefly describe chronologically your legal and other experience since your graduation from law school. Yes No a) Did you serve as a law clerk to a judge? If yes, what is the name of the judge, the court, and the dates of the period you were a clerk. 3 Application for Harris County Criminal Hearing Officer

Yes No b) Did you practice law alone (as a solo practitioner)? If yes, list the addresses and the dates. c) Please list the dates, names and address of law firms or offices, companies, governmental agencies, or other organizations with which you have been connected, and the nature of your connection with each. Yes No 23. Have you ever been engaged in any occupation, business or profession other than the practice of law, law teaching, or holding judicial or other public office? If so, give details including dates. Yes No 24. Are you now an officer or director or otherwise involved in the management of any business enterprise? If so, give details. Please read each question carefully. Although you may estimate your response, the response must be in discrete numbers (i.e., 4, 12, 31). Do not answer in ranges (i.e., 5-10, 10-50). Do not answer with phrases such as more than 20 or at least 100. 25. How many total felony criminal cases have you tried to conclusion before a jury. 26. How many total misdemeanor criminal cases have you tried to conclusion before a jury? Indicate areas in which you have unique training or skill. (You may attach any applicable documentation or certification.) 27. Mental health cases 28. Level V deaf interpreter 29. Fluent in the following language(s) other than English: 30. Other training or skill (Please describe): OPTIONAL INFORMATION ADDITIONAL EXPERIENCE List and describe other activities you have participated that relate to criminal law. 31. Speaking: 32. Teaching: 33. Legal Publications: 4 Application for Harris County Criminal Hearing Officer

34. Please include any other information you wish to be considered that you believe makes you uniquely qualified to be a criminal hearing officer. 35. I belong to the following professional organizations or associations: JURAT Applicant s signature SWORN TO and SUBSCRIBED before me on (date). My commission expires: Notary Public in and for The State of Texas 5 Application for Harris County Criminal Hearing Officer