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FORMAT OF APPLICATION FOR EMPANELMENT AS LEGAL AID COUNSEL
(Not to be filled by hand)
Application No._______________(For Office Use)
APPLICATION FOR EMPANELMENT AS LEGAL AID COUNSEL FOR
(-----FAMILY COURTS---------------------)
(CENTRAL OFFICE, DSLSA/ CONCERNED DISTRICT LEGAL SERVICES AUTHORITY, for COURTS/TRIBUNALS/COMMISSIONS – SESSIONS, ADJs, FAMILY, MAGISTERIAL, CIVIL, CAT, AFT, NGT, DST, DRT, NCDRC, SCDRC,) (MENTION ANY ONE IN THE SPACE ABOVE)
1. Applicant’s Name :__AMRIT PAL KAUR____________________________
2. Father’s / Husband’s Name : _HARBHAJAN SINGH___________________________
3. Date of Birth : ___19.01.1959_______________________________
(Words :_NINETEEN JANUARY NINETEEN FIFTY NINE_)
4. Age (as on 30.11. 2013 ) : _____54_____________________________________
5. Gender : _____FEMALE________________________________
1. Residential Address : __WZ-56, 2ND FLOOR , STREET NO. 9, _____________
_ __VIRENDER NAGAR, NEW DELHI-110058__________
7. Office Address :__WZ-56, 2ND FLOOR , STREET NO. 9, _____________
_ __VIRENDER NAGAR, NEW DELHI-110058__________
____________________________________________
Chamber Address : _CH-322, Lawyer’ Chamber_____________________
_ Distt. Court, Sector -10_ Dwarka_______________
_New Delhi-110075__________________________
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Telephone No. (O) : ______________--------________________________Telephone No. (R) : ______________--------_________________________Mobile No. : _9560678195, 9971354966, 9818604716__________Fax No. : ______________--------_________________________e-mail : [email protected], [email protected]______
8. Educational Qualifications:
Course Name of Board/University Year of Passing
Pass% (Aggregate)
Graduation Punjabi University, Patiala 1979 58.0 %
Professional Degree (LL.B) Punjabi University, Patiala 1987 60 %
Post Graduation (LL.M)
(if any)
- - -
9. Date of Enrolment as an Advocate : ____22.02.2001___________________
10. Enrolment No. : ___D-286/1-2001_________________ (Attach an attested copy of enrolment certificate)
11. Practice Experience (Duration of actual practice for which applied): _ 11 yrs_____(Attach an experience certificate issued by the Bar Association/Council)
(a) Total No. of cases handled : 24(b) Nature of cases handled : Civil, Matrimonial, Criminal, Section-138 N.I. Act
(Attach extra sheet, if required)
12. Specify whether earlier remained on the panel of the Delhi State Legal Service Authority or any other Institution/Government Department (please √ in the concerned column)
If remained on the panel of Delhi State Legal Service Authority
Yes No √
Specify names of PSU /Government Department dealt with, if any :
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________________________---___________________________________
14. Whether any disciplinary case/complaint was against the applicant with any Bar Council/DSLSA?
Yes No √
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15. List of the documents to be attached in soft scanned format:-
Attested copy of Degree of Law. Attested copy of Certificate of Enrolment issued by the State Bar Council
under the Advocates Act, 1961. Attested copy of Experience Certificate issued by the Bar Association.
(Paste soft copy of your Signature)
DECLARATION
I hereby declare that all the statements made in this application are true, complete
and correct to the best of my knowledge and belief. In the event of any information
being found false /incorrect at any stage, my candidature is liable to be cancelled. I
have read and understood the instructions and terms and conditions of the
empanelment and agree to abide by those. I declare that I fulfill the eligibility
conditions for the category to which I am seeking empanelment. I have not
submitted any other application for empanelment, besides the present one.
Place: __NEW DELHI_____Date: __31.12.2013______
(Paste soft copy of your Signature)
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