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. Applicants Name
:__AMRIT PAL
KAUR____________________________
2. Fathers / Husbands 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__________

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7. Office Address

:__WZ-56, 2ND FLOOR , STREET NO. 9,

_____________

__VIRENDER NAGAR, NEW DELHI-110058__________

____________________________________________
Chamber Address
:
Chamber_____________________

_CH-322,

Lawyer

_ Distt. Court, Sector -10_

Dwarka_______________
_New Delhi110075__________________________

Telephone No. (O)

: ______________--------________________________
Telephone No. (R)
:
______________-------_________________________
Mobile No.
:
_9560678195,
9971354966,
9818604716__________
Fax No.
:
______________-------_________________________
e-mail
:
p.amrit19@yahoo.com,
p.amrit09@gmail.com______

8.

Educational Qualifications:
Course

Name of Board/University

Graduation

Punjabi

Year of
Pass%
Passing (Aggrega
te)

University,

1979

Patiala
Professional

Degree

(LL.B)

%
Punjabi

University,

1987

60 %

Patiala

Post Graduation (LL.M)

(if any)
9.

58.0

Date of Enrolment as an Advocate :

____22.02.2001___________________
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10. Enrolment No.

:
___D-286/12001_________________
(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
:
(b)
Nature of cases handled
: Civil,
Section-138 N.I.
Act
(Attach extra sheet, if required)
12.

24
Matrimonial,

Criminal,

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 :

________________________---___________________________________
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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