Electronic Filing Registration Form

This form is used to register for an account on the Southern Bankruptcy of Ohio Case Electronic Filing System. Registered users will have privileges to electronically submit and file documents. By registering, users consent to receiving electronic notice of filings through the system. Completion of the following fields is required for registration:

	Required Information  **
	Type of Registration: ** Attorney   Limited User Limited to filing: Proofs of Claim, Applications to Withdraw Unclaimed Funds, Notices of Transferred Claims, Reaffirmation Agreements, and Appraisals.
	First Name:  **
	Middle Name:
	Last Name: **
	Generation:			Jr. Sr. II III IV
	Highest State Court Admitted: **
	Bar ID Number: **			State of:  **  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
	Firm/Company Name:
	Business Address: Street **
	Business Address: City **
	Business Address: State **			Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
	Business Address: Zip Code **
	Phone Number (with area code): **
	Fax Number (with area code):
	Email Address: **
	Email Address: Confirm **

	Once your registration is complete, you will receive notification by email of your user id and password.