QUIAPO OFFICE PANDACAN OFFICE

(02) 735-6011 local 6120 3rd Floor, Legal Council Office Sinag sa Sais Community Center
sbc.legalaid@gmail.com Pope Benedict XVI Building M. Carreon Street cornrer PNR Railway

SAN BEDA LEGAL AID BUREAU MAIN OFFICE

Minor Basilica of the Black Nazarene
910 Plaza Miranda, Quiapo, Manila
TTH 8AM-11AM
Pandacan, Manila
F 9AM-12NN

LAB FORM San Beda University Manila GMA-SUMBUNGAN NG BAYAN

DSWD-NCR OFFICE 2nd Floor, GMA Kapuso Center
638 Mendiola Street 389 San Rafael corner Legarda Street GMA Network Drive corner Samar Street
San Miguel, Manila 1005 Sampaloc, Manila Diliman, Quezon City
MWTH 9AM-12NN F 9AM-12NN F 9AM-12NN

NATURE OF ASSISTANCE Legal Representation Drafting of Document

Please check (/) applicable box(es) Legal Advice/Consultation Others, please specify _______________________
OFFICE Mendiola Pandacan Quiapo DSWD GMA
DATE DAY TIME
TO BE ACCOMPLISHED BY THE CLIENT
NAME OF CLIENT AGE SEX
OCCUPATION CIVIL STATUS
ADDRESS
CONTACT NUMBER E-MAIL ADDRESS
HAVE YOU PREVIOUSLY APPLIED FOR
YES Please specify: ___________________________________ NO
LEGAL ASSISTANCE IN THIS MATTER?
TO BE ACCOMPLISHED BY LEGAL INTERN(S)
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ADVERSE PARTY(IES) ______________________________________________________________________________________

FACTS OF THE CASE (use back of the page if necessary)

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ARGUMENTS OF THE PARTIES
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STATUS OF THE CASE
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ISSUE(S)
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ADVICE/ASSISTANCE GIVEN
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FOR LEGAL REPRESENTATION ONLY
I UNDERSTAND THAT MY APPLICATION IS SUBJECT TO THE APPROVAL OF THE LEGAL AID BUREAU DIRECTOR.
(NAUUNAWAAN KO NA ANG AKING APLIKASYON AY NAKASALALAY SA MABUTING PAGPAPASYA NG LEGAL AID BUREAU DIRECTOR).

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SIGNATURE OVER APPLICANT’S PRINTED NAME
RECOMMENDABLE FOR CERTIFICATE
YES NO YES NO To be followed on: ______________
REPRESENTATION? OF INDIGENCY (Please indicate the date)

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DOCUMENTS ____________________________________________________ _______________________
____________________________________________________ LEGAL
SUBMITTED _______________________
____________________________________________________ INTERN(S)
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Please attach supporting documents regardless if for legal representation or not.