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The undersigned applies for admission to practice as an attorney in Connecticut, and in support of such application submits the following sworn statement and attachments. This application is a continuing application and I will notify the Bar Examining Committee of any changes in any information provided herein. I have read the Rules and Regulations Governing Admission to the Bar and the Rules of Professional Conduct.
Applicant Information
Full Name
John Smith
Name as you wish it to appear on your admission certificate
Place of Birth (City/State/Country)
Carlisle, FL
Date of Birth
January 10, 1961
Social Security Number
***-**-****
[Pursuant to 42 U.S.C. § 666 (a) (13) (A), applicants are advised that providing their Social Security Number is required. The information is requested pursuant to Practice Book § 2-4 and Article III of the Regulations of the Bar Examining Committee. The information will be used to match various records with your file.]
NCBE Number
N10000000
Email Address
sample@email.com