USCA Form 82 Dec. 2020 (REVISED)

CERTIFICATE OF GOOD STANDING REQUEST FORM

A certificate of good standing may be requested in writing by letter or submitting this completed form to the address above along with the certification fee of $20.00 each. Please make check payable to "Clerk, US Court of Appeals". Or you may request the certificate in person at the address above between the hours of 9:00 a.m. to 4:00 p.m.

Please provide the name of the attorney who wishes the certificate and the address to which the certificate is to be mailed.

Name:

Address:

Phone:

Date of Admittance:

Check/Money Order No.

I have enclosed a check/money order in the amount of $20.00.

UNITED STATES COURT OF APPEALS DISTRICT OF COLUMBIA CIRCUIT

333 Constitution Avenue, NW Washington, DC 20001-2866

Phone: 202-216-7000 | Facsimile: 202-219-8530