Sr. No.

B
Dated

Declaration Form to be submitted by

the Advocates enrolled after 1" January, 2019
Passport size
1, Name
Photograph of
Advocate

2. Father's Name

3. Present Address

4. Enrolment Number Dated

5. Place of Practice

6. When did youpass your AIBE?

AIBE RollNo. (Attach the copy of COP)

7. Name of Bar Association/Place where you want to cast your vote in the election of

Bar Association

8. Place where you intend to cast your vote in the elections of State Bar Council

9. Whether, after getting enrolled you are in practice or have joined sonie job, business,
etc. (give details)

continued....
 B
-2
enrolment, whether you
10. lf you have not passed the AIBE within two years of your
State Bar Council?
have left practice and informed your Bar Association and
(give details)

11. Details of qualification

Year of
SL Roll No.
No.
Name of the Board/University Passing
A. Secondary Exam

B. Senior Secondary/
Intermediate (+2)

C Graduation

D. LL.B.

given above are true and correct. If

Ido hereby declare that all the inforamtions
then I will be liable to be prosecuted under
any of the informations are found to be false,
the Crimínal Law.

Signature of
Dated:
Candidate
Recommended By

& Full Signature with name

Full Signature with name of Presiden/ Secretary
ofAuthorised Member
Bar Association (seal)
Bar Council of Punjab and Haryana Dated;
Dated ;