The undersigned is an attorney member of the Butler County Bar Association [BCBA]. The undersigned agrees to the below terms, to rules and policies issued by court administration, and to the rules and policies issued by the Butler Sheriff.

1. The attorney shall pay a biennial application fee of $50.00, payable to the “Butler County Bar Association.” If paid through the BCBA website by card, the attorney shall pay the finance charge.
2. The attorney understands the keycard will permit the attorney to bypass court security checkpoints; and it permits access through “Attorney Access Level” doors in the Government Services Center courthouse. The attorney understands that briefcases, bags, and similar personal effects will be scanned at checkpoints.
3. The attorney may not under any circumstances loan a keycard to anyone—including staff. Nor shall an attorney who has been issued a card permit anyone else to access the “Attorney Access Level” doors when they do. i.e., they cannot permit someone else who does not have a card to follow through an access door with them.
4. The attorney must immediately report a lost keycard to the Manager of Court Administration at (513)785-6550 to enable deactivation of it. Once deactivated, the attorney may reapply for a second card through BCBA. There is an additional $50.00 fee. Failure to notify the Manager of Court Administration of a lost keycard may result in the permanent loss of keycard privileges.
5. The attorney’s keycard privileges may be revoked by the BCBA upon the attorney’s failure to maintain his or her membership in the biennium. And it may be revoked by court administration or the Butler Sheriff for failing to follow this agreement or the rules for attorney-access doors or checkpoints.
6. Upon approval of this application, with consent from court administration and the Butler Sheriff, the Butler Sheriff shall issue the keycard to the attorney at its offices.

The undersigned attorney hereby agrees to abide by the terms of the Attorney Security-Access Agreement as acknowledged by his or her signature below.

Attorney Name: Date Signed: Business Phone: Business Address: Email: Cell Phone:

RETURN THIS FORM WITH $50.00 TO THE BUTLER COUNTY BAR ASSOCIATION AT 1501 FIRST AVENUE, MIDDLETOWN, OHIO 45044.

---

Payment

Total: $50.00

The Butler County Bar Association© charges a 0.029% + $0.30 processing fee on all credit card payments.

Payment Information

First Name (on card) Last Name (on card) Address City State ZIP Code Country Phone # Email Address Credit Card Type American Express Discover MasterCard Visa Credit Card Number Expiration Month January February March April May June July August September October November December Expiration Year 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 CVV

---

Submit

---

BCBA USE ONLY

Application form and $50 received date of: Initials: Application reviewed and accepted date of: Initials: (Notify applicant of acceptance or rejection of application) Initials: Application form emailed to Manager, Court Administration At: courtadmincal@bcohio.gov Initials: on the date of: Initials:

---

COURT ADMINISTRATION USE ONLY

Application received by Court Administration on the date of: Initials: Application forwarded to Butler Sheriff on the date of: Initials: