Bar Council Of Delhi

The Secretary,

Trustee Committee,

Delhi Advocates’ Welfare Fund

1-F, Lawyers Chambers, High Court of Delhi,

Sher Shah Road, New Delhi – 110003

1. Name of the applicant (in block letters):

2. Father’s Name /

Husband’s Name

3. Age and Date of Birth (attach proof):

4. Address(Residence):

Pin:

Telephone

Fax

E-mail

5. Address (Office):

Pin:

Telephone

Fax

E-mail

5. Date of Enrolment as an Advocate and its Number with the Bar Council (attach copy of Enrolment Certificate)

6. Date since practising as Advocate:

7. Usual place(s) of practice (also give name(s) of the Court/Tribunal/Other Authority):

8. Name of the Association of Advocates of which the applicant is a member through which the applicant claims benefit under the Act:

9. Whether practice discontinued for any period and reasons therefor:

10. Whether the applicant is in part/full-time service; if yes, give particulars:

11. Name and address of the nominee (s); the amount or share payable to each of the nominees(s):

12. Name, age, occupation and other particulars of dependent (s):
(Note: Attach separate sheet, if necessary)

DECLARATION

I hereby declare that the above particulars are true to my, personal knowledge.

I hereby undertake to abide by the provisions of the Act, Rules and directions, etc. made thereunder.

I further declare that if any statement of fact stated in this Application is found to be false at any time, my name shall liable to be struck off as a member of the Fund.

Signature of the Applicant Advocate