10.3-c-application-declaration-military.pdf (2024)
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BOARD OF PROFESSIONAL RESPONSIBILITY
OF THE
SUPREME COURT OF TENNESSEE
APPLICATION FOR STATUS CHANGE
PURSUANT TO TENNESSEE SUPREME COURT RULE 9, SECTION 10.3
Pursuant to Tenn. Sup. Ct. R. 9, Section 10.7 (a), an attorney who claims an exemption under Section 10.3
(a),(b),(d) or (e) shall file with the Board an application to assume inactive status and discontinue the
practice of law in Tennessee. An attorney who claims an exemption under Tenn. Sup. Ct. R. 9, Section
10.3(c) shall file an application with the Board for status change. In support of the application, the attorney
shall file an affidavit or declaration under penalty of perjury stating that the attorney is not delinquent in
paying the privilege tax imposed on attorneys by Tenn. Code Ann. § 67-4-1702, is not delinquent in
meeting any of the reporting requirements imposed by Rules 9, 21, and 43, is not delinquent in the
payment of any fees imposed by those rules, and is not delinquent in meeting the continuing legal
education requirements imposed by Rule 21.
The undersigned attorney hereby makes application for the following exemption (please check (one only
please)):
____ Section 10.3 (a) – Inactive – Federal
____ Section 10.3 (b) – Inactive – Retired (pursuant to Tenn. Sup. Ct. R. 9, § 2 (Definitions))
____ Section 10.3 (c) – Active – Military Exempt
____ Section 10.3 (d) – Inactive – TN Law School Faculty
____ Section 10.3 (e) – Inactive – Not practicing in Tennessee
By making this application, I am aware that an attorney who assumes inactive status under an exemption
granted by Section 10.3(a), (d), or (e) shall pay to the Board, on or before the first day of the attorneyâs
birth month, an annual inactive-status fee in an amount equal to one half of the total annual fee set forth in
Section 10.2(c).
Further, I am aware that this change in status exempts me from annual reporting requirements with the Tennessee
Commission on Continuing Legal Education.
_______________________________________ _______________________________________
Printed Name Signature
_______________________________________ _______________________________________
BPR Number (required) Email address (required)
Instructions to attorney: Complete and return this application and the following affidavit to the Board by
mail (see the address below) or by email (registration@tbpr.org). Please be aware that any registration
requirement due on or before the date your affidavit is received by the Board must be paid before your
status may be changed. You are advised to contact the Tennessee Commission on Continuing Legal
Education to determine the requirements for completion of CLE while your law license is exempt (if any).
Board of Professional Responsibility
ATTN: Registration Department
10 Cadillac Drive, Suite 220
Brentwood, TN 37027-5078
BOARD OF PROFESSIONAL RESPONSIBILITY
OF THE
SUPREME COURT OF TENNESSEE
DECLARATION IN SUPPORT OF REQUEST FOR EXEMPTION
PURSUANT TO TENNESSEE SUPREME COURT RULE 9, SECTION 10.3(c)
I, __________________________, BPR #______________, declare under penalty of perjury,
that the following statements are true and correct:
1. I am currently serving in the United States armed forces on active duty and wish to claim the
exemption afforded by Tenn. Sup. Ct. R. 9, § 10.3 (c);
2. I am not delinquent in meeting any of the reporting requirements imposed by Tenn. Sup. Ct.
Rules 9, 21, or 43;
3. I am not delinquent in the payment of any fees or penalties imposed by Tenn. Sup. Ct. Rule 9;
4. I am not delinquent in meeting any continuing legal education requirements imposed by Tenn.
Sup. Ct. R. 21;
5. I am not delinquent in paying the Professional Privilege Tax imposed on attorneys pursuant to
Tenn. Code Ann. § 67-4-1702; and certify that I have paid all previously assessed Professional
Privilege Tax.
Witness my hand and seal this the _________ day of ______________________________, 20_____.
_______________________________________ _______________________________________
Printed Name Signature
_______________________________________ _______________________________________
BPR Number (required) Address (Mailing Address Only)
_______________________________________ _______________________________________
Email address (required) City, State, Zip Code
For Board of Professional Responsibility Use Only
Professional
BPR Good Disciplinary CLE
Type Privilege
Standing? history? Objections?
Tax Paid?
Military
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| ModifyDate | Tuesday, March 10, 2026 12:07 PM +02:00 |
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