DELHI HIGH COURT LEGAL SERVICES COMMITTEE
3338, Lawyers Chamber, Delhi High Court, New Delhi
Tel. No. 23383418, 43010101 Extn. 4381
Email : hclsthebest@yahoo.co.in
______________________________________________________________________________________________
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APPLICATION FORM
Application No._______________ (to be allotted by DHCLSC)
(To be filled by the candidate)
Application for empanelment of :
(Please in one column as an applicant can apply for only one panel).
Criminal Panel
Civil Panel
Jail Visiting Panel
Mediator Panel
1. Applicants Name :
(In Block Letters)
_____________________________________________
2. Fathers / Husbands Name
3. Date of Birth
____________________________________________
____________________________________________
4. Age (as on 1st February, 2016)
5. Residence Address :
____________________________________________
____________________________________________
____________________________________________
6.
Office/ Chamber Address
____________________________________________
____________________________________________
____________________________________________
7.
Telephone No. (R) :
____________________________________________
Telephone No. (O) :
____________________________________________
Mobile No.
____________________________________________
e-mail :
____________________________________________
Enrolment No. : ___________________ Date of Enrolment : ________________
(Attach self attested copy of enrolment certificate).
8.
Actual practice experience (Duration of actual practice in the Courts): ___________
__
(Attach an experience certificate issued by the Bar Association/Council)
9.
Specify the Jail where the candidate intends to visit, if necessary :
(Please the column)
Tihar Jail
Rohini Jail
Not interested in Jail Visits
10.
Specify experience in :
High Court of Delhi/ Supreme Court of India _____________
District Courts / Labour Courts / MACT/ any other Fora _________________
11.
Specify whether ever remained on the panel of the Delhi High Court Legal
Services Committee or Delhi State Legal Services Authority, if yes, give details :
______________________________________________________________________________
______________________________________________________________________________
12.
Whether any disciplinary case/complaint is pending against the applicant with any
Bar Council/Authority or any criminal case is pending or has ever resigned / removed from
the panel of DHCLSC/ DSLSA. If yes, give details : ________________________________
______________________________________________________________________________
______________________________________________________________________________
13.
List of the documents to be attached
Self attested copy of Degree of Law.
Self attested copy of Certificate of Enrolment.
Self attested copy of Experience Certificate.
In case applying for Civil & Criminal Panel, any one copy of Judgment/ order
in which applicant argued before High Court of Delhi.
In case applying for Mediator Panel, copy of 40 hours mediation training
certificate.
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 shall be liable to be rejected. I have read and
understood the instructions and terms and conditions of the empanelment and agree to
abide by them. I declare that I fulfill the eligibility conditions for the category to which I am
seeking empanelment. I am submitting only one application for empanelment.
Place: ________________
Date: ________________
(Signature of the Applicant)
