Del. R. Sup. Ct. Form 3
IN THE SUPREME COURT OF THE STATE OF DELAWARE
REPORT OF CHANGE OF STATUS UNDER RULE 55.1
Registrant holding a Delaware Certificate of Limited Practice hereby gives notice to the Court that
[His/Her employment with________________, whose address is ______________and whose telephone number is ___________, has ended effective as of [Date].]
[His/Her active membership in the Bar of [Jurisdiction] has changed to inactive/emeritus/senior status effective as of [Date]]
[He/She is the subject of disciplinary measures imposed by the Bar of [Jurisdiction] effective as of [Date]. The nature of these disciplinary measures is as follows: [Describe the matter and the sanction imposed].]
Registrant is aware and acknowledges that his/her Certificate of Limited Practice granted by this Court on [Date] is hereby revoked and ended as of the date hereinabove written.
Signature of Registrant
Dated: ____________
_________________________
Printed Name of Registrant
Delaware Bar Identification Number
[Address]
[Telephone Number]
[Electronic Mail Address]
Del. R. Sup. Ct. Form 3