Rhode Island Bar Association Web Site

Notice and Certification of Compliance
Interest on Lawyers Trust Account Program

I hereby declare compliance with the Rhode Island Supreme Court Rule 1.15 (d) by completing Parts I, II, and III and returning form on or before January 31, 2002.

Part I (*NOTE: If you are a member of a firm of two or more, one form may be completed on behalf of the firm. A listing of all lawyers and their Bar # must be included)

Name
Bar#
Firm
Address
City	State Zip
Telephone	Fax
Date	- mm/dd/yy

Part II (Please check on box) *Note: Box 2 & 3 are opt-out boxes.

	I would like to participate in the Rhode Island IOLTA Program. I presently have a non-interest bearing account(s) with the financial institution listed below and hereby direct said institution(s) to convert the non-interest bearing account(s) listed below to an IOLTA account. The interest will be paid by the financial institution directly to the Rhode Island Bar Foundation. Taxpayer ID#05-6009376.
	I certify that I do not have a Rhode Island client account which is subject to the IOLTA Rule because of my professional standing (retired, judiciary,not in practice of law, no legal activities in RI, public sector attorney, other). Please accept this as my notice to opt-out of the Rhode Island IOLTA Program. (DO NOT COMPLETE PART III)
	I certify that I do have a Rhode Island client account that is subject to the Rhode Island IOLTA Program. I choose not to participate. Please accept this as my notice to opt-out of the Rhode Island IOLTA Program. (DO NOT COMPLETE PART III)

Part III (Complete only if you checked box 1 in Part II)

	Account #1

Account Name
Name & Branch of Financial Institution
Trust Account Number

	Account #2

Account Name
Name & Branch of Financial Institution
Trust Account Number

Authorized Signature(s)	___________________________________
	___________________________________
	___________________________________

To submit your application you have two options:

Print the application and fax/mail it to us: Rhode Island Bar Foundation 115 Cedar Street Providence, RI 02903 Fax # (401) 421-2703	Submit the application electronically. You will receive a notification by e-mail that we received your application:

Thank you for your cooperation. For additional assistance, contact Ginny Caldwell, IOLTA Coordinator at (401) 421-6541 or via email at gcaldwell@ribar.com

Notice and Certification of Compliance Interest on Lawyers Trust Account Program

Notice and Certification of Compliance
Interest on Lawyers Trust Account Program