DECLARATION FORM

(For those Advocates who have a practice of less than five years)

Online Generate Application No: SBC20230900010591

To
The Secretary
State Bar Council of Madhya Pradesh
High Court Campus,
Jabalpur

Name : MANISH GEHLOT Father's Name : DHAN SINGH

Email Id gehlotm426@gmail.com Mobile No : 7970163980

Enrolment No and Date : 5513 ( 13/12/2021 )

State MADHYA PRADESH District : INDORE

Address : flat no 104, 61 shanti sephire, shivdham colony, limbodi, indore
Pincode : 452001
Place where the Advocate to cast his vote in the election of
State Bar Council : INDORE , INDORE
Name/Place of Bar Association Where the Advocates casts his
vote : HIGH COURT BAR ASSOCIATION INDORE MP .
Place : INDORE(H.C.BAR ASS.)
That since my enrolment as an advocate, I have not switched over to any other profession / services /
business and that thereafter, I am doing practice in law

Full Name: MANISH GEHLOT

Signature of the declarant Advocate

Date :10/09/2023