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NIGERIAN BAR ASSOCIATION Attach Your

STAMP APPLICATION FORM Photograph

Surname Other Names

Name as Verified

SAN Yes No Email: ..........................................................................................................................

Year of Call to Bar: Enrollment/Call No. GSM No.


SS CC NN

PLEASE INDICATE TYPE OF PRACTICE BY TICKING THE BOX BELOW:

Private Legal Practice:


Others:
Public Legal Practice: Government Banks University Others

Name of Employer/ Place of work

Contact Address:

NBA Branch: .........................................................

COST BANK DETAILS

· Option I- Pack of 96 Stamps (4 Sheets) N 4,000:00


ACCOUNT NAME: - NIGERIAN BAR ASSOCIATION
· Option II- Pack of 48 Stamps (2 Sheets) N2, 000:00 BANK: - ACCESS BANK
ACCOUNT NUMBER: - 0694192920
INDICATE NUMBER OF PACKETS

COLLECTION POINT: INDICATE BY FILLING THE SPACE BELOW:

NBA Branch Name ………………………………………………………………………………………………………………………… ………


Access Bank Branch …………………………………………………………………………………………………………………………………
(Please specify Branch Address)

Note: - Please note that only lawyers whose data has been verified and stored in the NBA database will be
able to process application for stamp. Please forward your form to your Local Branch Chairman, with the
original copy of your payment teller/receipt.

Approval by either: Branch Chairman Bencher SAN National Officer

Name:___________________________________ ___________________________
Signature

National Secretariat, NBA House, Plot 1101 Mohammadu Buhari Way, Central Business District, Abuja, FCT - Nigeria.
For further inquiries: Sarah: 08039177886, Ezekiel: 07037000903, Bar Service Hotline: 08175751180
Email: info@nigerianbar.org.ng Website: www.nigerianbar.org.ng

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