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\nNew York State Supreme Court Appellate Division  \nForm Law School Certificate  \nInstructions: Applicant must complete the first portion of this form certificate, sign the form and send it to each law school listed by the applicant on the application for admission questionnaire (see question number 10).  \nThe law school should complete the remainder of the form and return it directly to the Appellate Division Department designated below by the applicant.  \nCompletion and submission of this form is a prerequisite to applicant’s admission to the New York State Bar.  \nTO BE COMPLETED BY APPLICANT:  \nName of Applicant BOLE ID \\# (NYS Board of Law Examiners Identification Number)  \n  B  Current Street Address (Office or Home) City/Town/Village  \n\n| State | ZIP |  | Country (if not USA) |\n| --- | --- | --- | --- |\n| Telephone | E-mail |  |  |\n| Social Security Number |  |  |  |\n| Name of School |  |  |  |\n| Address of School | City/Town/Village |  |  |\n| State | ZIP | Country (if not USA) |  |\n\nTO BE COMPLETED BY SCHOOL ONLY:  \nDates of Attendance at Law School From (mm/yyyy) To (mm/yyyy)  \nDegree Conferred by School  \nAUTHORIZATION BY APPLICANT  \nI (name of applicant) ,   , hereby authorize (name of school)   and persons issuing this certificate to release to the Appellate Division of the New York State Supreme Court all information, files or records requested by it or its Committees on Character and Fitness in connection with the processing of my application for admission to the Bar of the State of New York.  \nSignature of Applicant    \nDated (mm/dd/yyyy)    \nApplication for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York: Form Law School Certificate (11/2020) Page 1 of 3  \nApplication for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York  \nForm Law School Certificate (Continued)  \nDesignation of Appellate Division Department to Which School Should Mail Completed Form:  \nApplicant must check one of the following:  \nFirst Judicial Department  \nCommittee on Character and Fitness, Appellate Division, First Department  \n41 Madison Avenue, 26th Floor, New York, New York 10010  \nTelephone: (646) 386-5893  \nSecond Judicial Department  \nCommittees on Character and Fitness, Appellate Division, Second Department  \n335 Adams Street, Room 2404, Brooklyn, New York 11201  \nTelephone: (718) 923-6360  \nThird Judicial Department  \nAttorney Admissions, Appellate Division, Third Department  \nP.O. Box 7350, Capitol Station, Albany, New York 12224  \nTelephone: (518) 471-4778  \nExpress Mail Address:  \nAppellate Division, Third Department Attorney Admissions  \nRobert Abrams Building for Law and Justice  \nState Street, Room 511, Albany, New York 12223  \nFourth Judicial Department  \nAttorney Admissions, Appellate Division, Fourth Department  \nM. Dolores Denman Courthouse, 50 East Avenue, Suite 200, Rochester, New York 14604  \nTelephone: (585) 530-3100  \nApplication for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York: Form Law School Certificate (11/2020) Page 2 of 3  \nApplication for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York  \nForm Law School Certificate (Continued)  \nTO BE COMPLETED BY SCHOOL ONLY:  \nPlease confirm whether or not the school information provided by applicant above is accurate.  \nYes No (if “No” please explain)  \nWas applicant charged with any misconduct, or disciplined, suspended, or dropped for any misconduct?  \nYes No (if “Yes” please state fully)  \nIs there any other discreditable information in the personnel or other records of the school regarding the applicant’s conduct or activities or bearing upon applicant’s character not otherwise set forth in this form certificate?  \nYes No (if “Yes” please state fully)  \nIf applicant filed a questionnaire or written application containing personal data, ","cbCaiii2QuerPcyk","https://ap.wps.com/l/cbCaiii2QuerPcyk","pdf",228953,"English","# Applicant and School Responsibilities\n## Applicant: Complete, sign, and authorize release of records\n## School: Confirm attendance, degree, and accuracy of applicant data\n## School-only disclosures and official signature\n# Appellate Division Department Mailing Instructions\n## First Judicial Department\n## Second Judicial Department\n## Third Judicial Department\n## Fourth Judicial Department\n# Language and Translation Requirement","[{\"question\":\"What are the applicant’s required steps for this law school certificate form?\",\"answer\":\"The applicant must complete the first portion, sign the form, and send it to each law school listed on the admission questionnaire. The applicant’s authorization section permits release of requested information for character and fitness processing.\"},{\"question\":\"What does the law school need to complete on the form?\",\"answer\":\"The school completes attendance dates, the degree conferred, confirmation of the applicant’s provided school information, and answers about any misconduct or other discreditable information. The school must include an official seal and signature with the official’s title and date.\"},{\"question\":\"Where should the completed form be mailed for each Appellate Division department?\",\"answer\":\"The form designates mailing locations and telephone numbers for the First, Second, Third, and Fourth Judicial Departments. The school must mail the completed form directly to the designated Appellate Division Department address listed on the certificate.\"}]","Application for Admission to Practice as an Attorney and Counselor-at-Law in the State of New York - Form Law School Certificate - Instructions and Submission Requirements | PDF",1789960446]