You are on page 1of 1

CLAS Form No.

004

Integrated Bar of the Philippines


________________________ Chapter
Office Address

CERTIFICATION
(Pursuant to A.M. No. 17-03-09-SC)

This is to certify that ATTY. NAME OF LAWYER with Roll of Attorneys No.
__________, a member of the IBP-__________ Chapter, has successfully completed
the required 120 hours of Community Legal Aid Service for the period Month & Year
STARTED to Month & Year COMPLETED under A.M. No. 17-03-09-SC otherwise
known as the “Rule on Community Legal Aid Service” per our records.

Atty. SURNAME OF LAWYER has actually rendered pro bono legal services for
a total of ACTUAL NUMBER OF HOURS IN WORDS (in figures) hours from DATE
STARTED to DATE COMPLETED consisting of representation of qualified
parties/litigants in trial courts, legal counseling and drafting of legal documents or
pleadings, to wit:

Brief Description of the


Title of the Case Venue Name of Party/Litigant Address of Party/Litigant
Nature of Legal Aid Service
Representation in the Title & Case Number Court & Branch Name/s Residential Address
trial court of a(civil or City/Province
criminal or admin) case
for (Nature of Case)

Preparation of a legal Title & Case Number Quasi-Judicial Agency Name/s Residential Address
document/pleading City/Province
(type of document) for
(Nature of Case)

Legal Counselling (not applicable) Place (IBP Office or Name Residential Address
(Re: NATURE OF Community)
LEGAL CONCERN)

The foregoing is based on the timesheet, certificates of appearance and Affidavit


of CLAS Compliance submitted by Atty. SURNAME OF LAWYER to this office.

Issued on this ______________, at the ___________________________.

ATTY. (NAME OF CHAIRPERSON)


Chairperson, Committee on Legal Aid

Noted by:

ATTY. (NAME OF CHAPTER PRESIDENT)


President

Page 1 of 1

You might also like