DELHI LEGAL SERVICES AUTHORITY Room No.-1, Patiala House Courts, New Delhi APPLICATION FORM FOR LEGAL AID 1. Name of Applicant : 2. Father’s/Husband’s Name : 3. Residential Address (Tel. No. if any) : 4. Whether Employed/Unemployed : 5. Place of Work : 6. Nationality & Religion : 7. Whether SC/ST (Proof in support of it) : 8. Income per month (Affidavit on Rs.10/- On non-judicial paper in support of it) : 9. Name and Address of opposite party & Tel. No. (if any) : 10. Whether legal aid is required to file : Suit/Application U/s 125 Cr. P.C./Civil (Please state the category) Writ/ Criminal Writ/ Labour Case/ Service Matter/Criminal Matter/ Other (pl. specify) (a) State the full address of immovable property in dispute and the place where property is situated : (b) In money suit, state the date on which it fell due. : 11. Whether any application has been filed previously before this Authority, if yes, mention date and file No. of application: 12. Details of your problem ( in brief) : 13. Please state whether any case is pending before, any court, if so, the details thereof: 14. Nature of relief sought : SIGNATURE OF THE APPLICANT REMARKS : Whether entitled to legal aid