Application for legal services Form ‘A’ Format in English

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                                                                       FORM ‘A’

APPLICATION FOR LEGAL SERVICES

[Rule 15 of the Meghalaya State Legal Services Authority Rules, 1998]

To,
The Member Secretary,
Meghalaya State Legal Services Authority,
SHILLONG.
The Secretary

High Court Legal Services Committee,

SHILLONG.

The Secretary,

District Legal Services Authority,

___________________________District________________

Sir,
I have the honour to request that the Legal Services may kindly be provided to me so that proper
steps can be taken on my behalf in the case the particulars and grounds of which are given below. Other
particulars in respect of my application are as follows:­
1. Name:­
2. Age:­
3. Permanent Address:­
4. Present Address:­
5. Community(Scheduled Castes:­ Scheduled Tribes or Other backward Class)

6. Occupation:­
7. Total annual income:­
8. Number of dependent family members:­
9. Nature of case/dispute and legal aid required:­
(State the parties involved or likely to be

involved nature of the case/dispute,

the origin of the case/dispute,

the claim or right sought to be

established/granted and any

other information or material

relevant to the case/dispute)

10. Whether legal aid/ legal services have been previously:­
applied for/granted. If so, give details.

I am not in a position to engage a lawyer and to pay court fees and other expenses in
connection with the legal proceedings on account of indigent condition. I certify that the statement
above is true to the best of my knowledge and belief.
I agree to repay the cost, charges and expenses that may be granted to me in the court passes a
decree or order awarding costs or other monetary benefits in my favour. For this purpose I do hereby
Authorise the State Authority/High Court Legal Services Committee/District Committee on my behalf
to recover the amount of costs or other monetary benefits which may be awarded to me in the above
legal proceedings by the Courts, charges and expenses incurred in providing legal services to me.

 

Yours faithfully,

Signature of the Applicant