Annexure 'D'

VAKALATNAMA
SUBMITTED BY AN AIDED PERSON UNDER THE PROVISIONS OF STATE
LEGAL SERVICES AUTHORITY RULES, 1996
In the Court of
Sh./Smt./Ms. ......................................................................................................................................
..
Criminal/Civil/Appellate/Original Jurisdiction
Civil/Suit/Appeal/Case No.
...............................................................of.....................................................................
..................................................................................................................... Appellant(s)/Plaintiff(s)/
Applicant(s)
VERSUS
.........................................................................................................................................Defendant(
s)/Respondent(s)
I/we .................................................................. son/daughter/wife of
Sh. ................................................resident of
.................................... District ...................................... the appellant(s)/plaintiff(s)/applicant(s) in
the above Civil Appeal/Suit/case hereby authorise the District Legal Services
Authority............................................................./ Sub-Divisional Legal Services
Committee, ................................................................. to appoint any advocate to act and appear
for me/us in the above
Civil/Suit/Appeal/Case and on my/our behalf to conduct and prosecute (or defend) the same and
undertake all proceedings that
may be required in respect of any application connected with the same or any decree or order
passed therein.
Signatures or thumb impression of the Appellant(s)/ ..........................
Plaintiff(s)/)/Applicant(s)/Defendant(s)/Respondent(s) Dated...........................................

DECLARATION
It is declared that no such or similar case has earlier been filed by me/us either in this Hon'ble
Court or in the Hon'ble High Court of Punjab and Haryana or in the Hon'ble Supreme Court of
India.

Signatures or thumb impression of the Appellant(s) ..............................................

Plaintiff(s)/Applicant(s)Defendant(s)/Respondent(s). Dated....................................................
(FOR OFFICE USE)
Mr./Mrs./Ms. ......................................................................., Advocate is appointed as Counsel for
the above named
appellant(s)/plaintiff(s)/defendant(s)/respondent(s).
Member Secretary, .
State Legal Services Authority,Chandigarh,
...............................................................
.
(...................................................................)
Advocate,
...................................................................
.................................................................