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Northern District of Illinois. Complete the Pro Hac Vice Certification form.It must include the Kentucky Court name and full case number for which the request is being made. Submission Checklist. Once granted, pro hac vice admission pertains to the individual attorney for the single case for a period of one year. Q: How do I become admitted pro hac vice at the Court of Appeals? The out-of-state lawyer must complete the online application and submit the application electronically. McIntosh, a non-admitted Lawyer and the affiant herein, having been duly sworn, states upon oath: 1. This certificate includes the attorney's full name, bar number and date of admission, name or status changes (dates of inactive, not eligible, etc. Excluded attorneys and pro hac vice attorneys must submit the enclosed paper form.