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IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRJCT OF VIRGINIA
APPLICATION TO QUALIFY AS A FOREIGN ATTORNEY UNDER LOCAL CIVIL RULE 83.l(D) AND LOCAL
CRIMINAL RULE 57.4
In Case Number 20-cv-00658
, Case Name Blue Flame Medical LLC v. Chain Bridge Bank, N.A. et al.
Party Represented by Applicant: Chain Bridge Bank, N.A., John J. Brough, and David M. Evinger
To: The Honorable Judges of the United States District Court for the Eastern District of Virginia
PERSONAL STATEMENT
FULL NAME (no initials, please)Carolyn
Michele
Bar Identification Number 230152
State District of Columbia
Firm Name Robbins, Russell, Englert, Orseck, Untereiner & Sauber LLP
Firm Phone # (202)775-4500
Direct Dial# (202)775-4493 FAX # (202) 775-4510
E-Mail Address cforstein@robbinsrussell.com
Office Mailing Address 2000 K Street NW, 4th Floor, Washington, DC 20006
Name(s) of federal court(s) in which I have been admitted U.S. District Court for the District of Columbia
l certify that the rules of the federal court in the district in which I maintain my office extend a similar pro hac vice admission
privilege to members of the bar of the Eastern District of Virginia.
I have not been reprimanded in any court nor has there been any action in any court pertaining to my conduct or fitness as a
member of the bar.
I hereby certify that, within ninety (90) days before the submission of this application, I have read the Local Rules of this Court
and that my knowledge of the Federal Rules of Civil Procedure, the Federal Rules of Criminal Procedure, and the Federal Rules of
Evidence is current.
lam am not
a full-time employee of the United States of America, and if so, request exemption from the admission fee.
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(Applicant's Signature)
I, the undersigned, do certify that I am a member of the bar of this Court, not related to the applicant; that I know the applicant
personally, that the said applicant possesses all of the qualifications required for admission to the bar of this Court; that I have
examined the applicant's personal statement. I affirm that his/her personal and professional character and standing are good, and
petition the court to admit the applicant pm hoc ,;LJ ~-----
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Typed or Printed Name)
(VA Bar Number)
Court Use Only:
Clerk's Fee Paid
or Exemption Granted
The motion for admission is GRANTED or DENIED
(Judge's Signature)
(Date)
Case 1:20-cv-00658-LMB-IDD Document 81 Filed 03/31/21 Page 1 of 1 PageID# 567