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CASE EVALUATOR APPLICATION

To serve as a case evaluator, you must meet the following qualifications.

• You must have been a practicing lawyer for at least 5 years.

• You must be a member in good standing of the State Bar of Michigan.

• You must reside, maintain an office, or have an active practice in the jurisdiction for which the list of case evaluators will be
compiled.

• You must demonstrate that a substantial portion of your practice for the last 5 years has been devoted to civil litigation
matters including investigation, discovery, motion practice, case evaluation, settlement, trial preparation, and/or trial.

If the court maintains sublists for specific types of cases (such as professional malpractice, commercial, labor and

•
employment), you must have had an active practice in those areas. For further information, refer to MCR 2.404.

Please type or print clearly.
1. Full name (first, middle intital, last)

3. Residence address

5. Business address (if different from residence address)

7. Current employer’s name

9. Previous employer’s name

11. Fax no.

( )
13. Date admitted to state bar

12. E-mail address

14. Years in practice

Part A: General Information

15. This is a

new application.

renewal.

2. Bar no.
P
4. Home telephone no.

( )
6. Business telephone no.

( )
8. Number of years with employer

10. Number of years with employer

16. Are you currently a member in good standing of the State Bar of Michigan?

Yes

17. Have you ever been disciplined by the Michigan Attorney Discipline Board or

any other state or federal agency or court? If yes, explain. Complete on separate pages if needed.

Yes

18. Provide information that demonstrates experience in civil litigation including investigation, discovery, motion practice, case
evaluation, settlement, trial preparation, and/or trial for the last 5 years. For any trial experience, include the name of the

case, the year of trial, the case number, the number of trial days, the name of the court, the name of the judge, and whether

you represented the plaintiff or the defendant. Complete on separate pages if needed.

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MC 34 (12/21) CASE EVALUATOR APPLICATION, PAGEMCR 2.404Case Evaluator Application, continued from page 1

19. Indicate the percent of your law practice for the past 5 years devoted to civil litigation matters, including investigation,

discovery motion practice, case evaluation, settlement, trial preparation, and/or trial.

Indicate the percent of your current trial practice in the following areas:

% plaintiff

% defense

Personal injury/Auto negligence

Professional malpractice

Product liability

Commercial

Labor and Employment

Condemnation

Domestic relations

Other

specify

% defense

specify

Part B: For Specialized Lists Complete Part B if the court maintains sublists for specific types of cases and you have had
an active practice in those areas for at least the last 3 years.

20. Indicate which you primarily represent:

a neutral alternative dispute resolution provider for a period of up to 15 years
prior to this application)
Indicate the sublist(s) you are applying for:

Plaintiff
Neutral (represent both plaintiffs and defendants or have served as

Defendant

21. List the areas of law in which you practice and how long you have practiced in each area.

Area of law Years practiced Area of law Years practiced

Part C: Additional Information

22. Provide any additional information about you that would be helpful in describing your qualifications to serve as a case

evaluator, for example, teaching law school courses. Complete on separate pages if needed.

% plaintiff

/ /

I certify that I meet the requirements for service under the court’s selection plan and that I will not discriminate against parties,
attorneys, or other case evaluators on the basis of race, ethnic origin, gender, or other protected personal characteristics.

Date

Signature

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MC 34 (12/21) CASE EVALUATOR APPLICATION, PAGEMCR 2.404Case Evaluator Application - Gender and Race Information to be maintained separately from pages 1 and 2 of application

Part D: Gender and Race Information

Providing the following information is optional. It is requested in accordance with MCR 2.404(B)(1) and will be maintained
separately from your application.

Bar no.
P

Full name (first, middle initial, last) (print or type)

Check the boxes that apply to you.

Gender:

Female

Male

Race/Ethnicity:

American Indian or Alaskan Native

Asian or Pacific Islander

Black/African American (non-Hispanic)

White/Caucasian (non-Hispanic)

Hispanic

Other

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MC 34 (12/21) CASE EVALUATOR APPLICATION, PAGEMCR 2.404

MC 34, Case Evaluator Application

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/case-evaluation (2023-03)
Page(s): 3
Fields(s): 89
Average fields per page: 29
Reading Level: Grade 12
LIST Grouping(s): CO-00-00-00-00, CO-07-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

full_name_first_middle_last was 1 Full name first middle intital last (0.59 conf)
bar_p__1 was 2 Bar no P (0.33 conf)
residence_address was 3 Residence address (0.35 conf)
home_telephone was 4 Home telephone no (0.47 conf)
address_different_residence was 5 Business address if different from residence address (0.41 conf)
business_telephone was 6 Business telephone no (0.50 conf)
current_employers_name was 7 Current employers name (0.38 conf)
number_years_employer__1 was 8 Number of years with employer (0.28 conf)
previous_employers_name was 9 Previous employers name (0.33 conf)
number_years_employer__2 was 10 Number of years with employer (0.28 conf)
fax was 11 Fax no (0.37 conf)
email_address was 12 Email address (0.41 conf)
date_admitted_state_bar was 13 Date admitted to state bar (0.40 conf)
years_practice was 14 Years in practice (0.36 conf)
new_application was new application (0.31 conf)
state_federal_agency_yes__1 was any other state or federal agency or court If yes explain Complete on separate pages if needed 1 (0.43 conf)
state_federal_agency_yes__2 was any other state or federal agency or court If yes explain Complete on separate pages if needed 2 (0.43 conf)
state_federal_agency_yes__3 was any other state or federal agency or court If yes explain Complete on separate pages if needed 3 (0.43 conf)
plaintiff_defendant_needed__1 was you represented the plaintiff or the defendant Complete on separate pages if needed 1 (0.40 conf)
plaintiff_defendant_needed__2 was you represented the plaintiff or the defendant Complete on separate pages if needed 2 (0.40 conf)
plaintiff_defendant_needed__3 was you represented the plaintiff or the defendant Complete on separate pages if needed 3 (0.40 conf)
plaintiff_defendant_needed__4 was you represented the plaintiff or the defendant Complete on separate pages if needed 4 (0.40 conf)
plaintiff_defendant_needed__5 was you represented the plaintiff or the defendant Complete on separate pages if needed 5 (0.40 conf)
renewal was renewal (0.42 conf)
yes__1 was yes2 (0.35 conf)
no1 was no1 (0.42 conf)
no2 was no2 (0.39 conf)
yes__2 was yes1 (0.35 conf)
plaintiff__1 was plaintiff (1.00 conf)
defense__1 was defense (0.40 conf)
personal_injury_auto was Personal injuryAuto negligence (0.47 conf)
professional_malpractice was Professional malpractice (0.50 conf)
product_liability was Product liability (0.52 conf)
commercial was Commercial (0.40 conf)
labor_employment was Labor and Employment (0.37 conf)
condemnation was Condemnation (0.36 conf)
domestic_relations was Domestic relations (0.29 conf)
other was Other (0.43 conf)
other_2 was Other_2 (0.44 conf)
plaintiff__2 was plaintiff_2 (0.54 conf)
defense__2 was defense_2 (0.40 conf)
plaintiff__3 was plaintiff_3 (0.54 conf)
defense__3 was defense_3 (0.40 conf)
plaintiff__4 was plaintiff_4 (0.54 conf)
defense__4 was defense_4 (0.40 conf)
plaintiff__5 was plaintiff_5 (0.54 conf)
defense__5 was defense_5 (0.40 conf)
plaintiff__6 was plaintiff_6 (0.54 conf)
defense__6 was defense_6 (0.40 conf)
plaintiff__7 was plaintiff_7 (0.54 conf)
defense__7 was defense_7 (0.40 conf)
plaintiff__8 was plaintiff_8 (0.54 conf)
defense__8 was defense_8 (0.40 conf)
specify__1 was specify (0.36 conf)
plaintiff__9 was plaintiff_9 (0.54 conf)
defense__9 was defense_9 (0.40 conf)
specify__2 was specify_2 (0.42 conf)
plaintiff__10 was plaintiff_10 (0.54 conf)
defense__10 was defense_10 (0.40 conf)
plaintiff__11 was Plaintiff (1.00 conf)
neutral_represent_plaintiffs was Neutral represent both plaintiffs and defendants or have served as (0.35 conf)
defendant was Defendant (1.00 conf)
indicate_sublists_applying__1 was Indicate the sublists you are applying for 1 (0.35 conf)
indicate_sublists_applying__2 was Indicate the sublists you are applying for 2 (0.35 conf)
evaluator_example_teaching__1 was evaluator for example teaching law school courses Complete on separate pages if needed 1 (0.37 conf)
evaluator_example_teaching__2 was evaluator for example teaching law school courses Complete on separate pages if needed 2 (0.37 conf)
evaluator_example_teaching__3 was evaluator for example teaching law school courses Complete on separate pages if needed 3 (0.37 conf)
evaluator_example_teaching__4 was evaluator for example teaching law school courses Complete on separate pages if needed 4 (0.37 conf)
signature_date was Date (1.00 conf)
text__1 was Text1 (0.35 conf)
text__2 was Text2 (0.35 conf)
text__3 was Text3 (0.35 conf)
text__4 was Text4 (0.35 conf)
text__5 was Text5 (0.35 conf)
text__6 was Text6 (0.35 conf)
text__7 was Text7 (0.35 conf)
text__8 was Text8 (0.35 conf)
text__9 was Text9 (0.35 conf)
name_first_initial_last_type was Full name first middle initial last print or type (0.39 conf)
american_indian_alaskan was American Indian or Alaskan Native (0.31 conf)
asian_pacific_islander was Asian or Pacific Islander (0.36 conf)
african_american_non_hispanic was BlackAfrican American nonHispanic (0.38 conf)
hispanic was Hispanic (0.36 conf)
white_caucasian_non_hispanic was WhiteCaucasian nonHispanic (0.30 conf)
other_3 was Other_3 (0.44 conf)
bar_p__2 was Bar no P (0.35 conf)
text__10 was Text10 (0.35 conf)
female was female (0.38 conf)
male was male (0.40 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

MC 34, Case Evaluator Application

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02