Section 81.504. Information to be Provided to IOLTA Board

(a) The following information shall be provided to the IOLTA Board with the fee required by Section 81.505:

(i) The name, address, contact information, and Supreme Court identification number of the active member of the bar of this Commonwealth who sponsors the applicant for pro hac vice admission.

(ii) The applicant’s complete name, date of birth, law firm address and other contact information.

(iii) The name and address of each court and a full identification of the case.

(iv) The courts before which the applicant has been admitted to practice, the respective period(s) of admission, and the applicant’s identification number in the jurisdiction(s) admitted.

(v) An averment that the applicant is familiar with the Pennsylvania Rules of Professional Conduct, the Pennsylvania Rules of Disciplinary Enforcement, and the rules and court procedures of the court before which the applicant seeks pro hac vice admission.

(b) Included as Appendix A to this regulation is a form which may be used to provide the information required by Section 81.504(a).