| Attorney's Name: |
___________________________________________ |
| Law firm (if any): |
___________________________________________ |
| |
|
| Address: |
___________________________________________ |
| |
___________________________________________ |
| |
|
| Phone number: |
___________________________________________ |
| E-mail: |
___________________________________________ |
| Fax: |
___________________________________________ |
| |
|
| City Bar Justice Center
Program: |
___________________________________________ |
| |
|
| Start Date: |
___________________________________________ |
| Complete Date: |
___________________________________________ |
| |
|
Description of
legal
services provided: |
___________________________________________ |
| |
___________________________________________ |
| |
___________________________________________ |
| |
___________________________________________ |
| |
|
Total number of
hours
spent: |
___________________________________________ |
| |
|
| AFFIRMATION: |
I hereby affirm
that I have performed the above-stated number
of hours of legal services in the above-referenced
City Bar Justice Center Program, and that such service
was uncompensated. |
| |
|
| Date submitted |
___________________________________________ |
| Attorney's signature |
___________________________________________ |
Attorneys may receive one (1) CLE
credit for every six (6) 50-minute hours (300
minutes) of eligible pro bono service. A maximum
of six (6) pro bono CLE credits may be earned
during any one reporting cycle.
