0

CIR

CU

IT C

OU

RT

OF ST

. LO

UIS C

OU

NTY

. ST

AT

E O

F MISSO

UR

I

NE

UTR

AL Q

UA

LIFICA

TION

FOR

M

Pursuant to Local R

ule 38

I am applying for Inclusion on the list of neutrals to be m

alritalned by'the Circuit C

lerk pursuant · to Local R

ule 38 of the Circuit C

ou1tof St. Louis C

ounty. Toe following Inform

ation Is supplied in support o

f this appllcat19n.

1. N

ame:· m

il\eR, 2.

3.

4.

5.

7.

(Last)

Address:

39 'J-.U . b '1 ~':€

, l \ 6

k.

jf.DJ

'

(Flrat) (M

iddle)

sT-h

ou

6

mo

b:s10'.R

(City)

(State)

(ZIP

+4)

Telephone N

umber: 'b

lY-5

°31

43

~

Facsimile N

umoer: 3) 4. ~ S

-~ \ ~ q "3 ~I

State the standard hourly fee for your services as a neutral.

4 s10D

l!SJ 0

M.12

a. ..... ,. 9.

0 flf the answ

er to any of the follow

! 1

on a separate sheet ~nd attach.] ng .quest ens is yes, please explain the circum

stances

Have you ever been disciplined i

1 1 11 responslbllit¥?

or v O a 0

~ of any code of professional ethics or

a.

b. H

ave you ever pied guilty to or been found guilty of a felony?

---

Have you ever been fotm

d liable for fraud or any other Intentional tort?

Have you ever had a professional llcens

. k d

than· non-payment o

f dues? .

_e _revo e or suspended for reasons other

c.

d.

e. H

ave any professional maipractfce Judgm

ents been entered aQalnst you?

-

List the courts and professional organiz ti I

a neutral, mediator arbitrator or other~·ooRn~ n w

,hlch you currently hold certifications as •

• "'

serv ce provider.

J~

---

7-J-CJ±

. (~~

THIS

FOR

M W

ILL BE

MA

DE

AV

AILA

BLE

TO TH

E P

AR

TIES

TO A

SS

IST

THE

M IN

CH

OO

SIN

G A

NE

UT

RA

L.

Js;

Joan K. Miller, LLC

A

ttorney at Law

3920 Lindell Blvd., S

te. 20

7

St. Louis, M

O 6

31

08

--------~~ ---

-~--------------

-----

--__ ,..._ __ .... ·------------

-~-----------------

---~

~---~

St. Louis C

ou

nty C

ircuit Cle

rk 7900 C

aro

nd

ele

t S

t. Louis, MO

63105

~ < I ~ ~~ >

lsamuN

oguch!1904-1988

l ....

\ '-''

........ ''.,' '''

R!e

r,vE

o

JUL O

9 2004

CIRcu,;gj~K.~PILMER

• • LOUIS C0Ufi11Y