ASSAM ADVOCATE’S WELFARE FUND RULES, 2005 FORMH Application Form under Section 15 for Admission as member of the Fund. (See Rule 22) To The Secretary, ‘Assam Advocates'Welfare Fund, Guwahati ‘member of the Fund, ‘Sub. : Application under Section 15 for admission Sir, | apply to be admitted as Member of the Fund, the detail particulars are given below: Pino, 1. Name 2. Father's Name: 3. Date of Birth: 4. Address: 5. Enrolment No. and date in the Bar Council: 6. Date since practising as: (a) Pleader (b) Advocate 7. Name of Bar Association of which the applicant is member: (Certificate of Recognised Bar Association be enclosed) 8. Period of Suspension of practice from... 9. Reason of suspension. 10. Whether the applicant was convicted by a Court of law for an offence of moral turpitu 41. Particulars of nomination: A. Name and age of the nominee B. Relationship ©. Address: D. Name of other legal heirs of Class | as per succession law (If there is more than one nominee, please specify the amount or share payable to each of them as to cover whole of amount payable) 12. Amount of Fees 100/- + 2000/- (Rs. 2100/-) 43, Cash or DID in Favour of “Assam Advocate's Welfare Fund” 14. Whether the applicant wes ever removed from membership of fund, if ‘So: When: Why. Date of revival 15. any other details: DECLARATION (A) [hereby deciare that the above particulars are true to my personal knowledge. (8) | hereby undertake to abide with the provisions of Act, Rules and directions etc. made thereunder: (C) I hereby undertake to pay subscriptions as required. Signature of Applicant Advocate. (PresidenSecretary)