Butler County Bar Association

Annual Dues Statement - Fiscal Year 2024 - 2025

(Fiscal Year 4/1/2024 - 3/31/2025)

Please return completed form with applicable payment by

March 31, 2024 (Postmarked)

Mail to: BCBA; 1501 First Avenue, Middletown OH 45044

Name: OH Supreme Court #: Organization / Firm: Office Address: Office Phone: Cell Phone: Fax: E-mail: Website: OH Supreme Court Admission Date:

Membership Dues (SELECT ONE CATEGORY)

Membership Type:

STANDARD MEMBERSHIP (OH Supreme Court Admission prior to 2022)	$165.00
EARLY STANDARD MEMBERSHIP DISCOUNT (IF POSTMARKED PRIOR TO DECEMBER 31, 2023)	$150.00
HONORARY MEMBERSHIP (OH Supreme Court Admission = 50+ years practice)	FREE
RETIRED MEMBERSHIP (OH Supreme Court current registration status = Retired)	$65.00
NEW LAWYER MEMBERSHIP (OH Supreme Court Admission in 2023 – 2024)	FREE

BAR FOUNDATION DONATION

DESIGNATED INVENTORY ATTORNEY INFORMATION

JOIN THE NEW LRS PROGRAM!

No monthly status reports to maintain
Only pay a nominal monthly or annual subscription fee
Participants retain all income generated by all LRS referrals

(For details and fees, see pages 8 - 16)

Payment Information

Payment Information First Name (on card) Last Name (on card) Address City State ZIP Code Country Phone # Email Address Credit Card Type Credit Card Number Expiration Month Expiration Year CVV