Price of form: - Rs.

50/- [Photo copy of this form will be not accept]

Form no.________ TBA No.__________

TAXATION BAR ASSOCIATION BIHAR, PATNA

(An Affiliated body of Bihar State Bar Council, Patna.)
Application For Membership

To,
The General Secretary Photo
Taxation Bar Association Bihar, Patna. (in Uniform)
)

1. Name of applicant:____________________________________________
2. Father’s name: _______________________________________________
3. Spouse name: _______________________________________________
4. Date of birth: _____________Residential address: __________________
________________________________________________
5. Permanent Address:-_________________________________________
_____________________________________________
6. Office address: ______________________________________________
_______________________________________________
________________________________________________
7. Telephone no.: ___________(O)_____________(R)__________(M)____
8. E-mail Id (in block letter): ________________________________
9. Number & date of registration with Bar Council (attach photo copy): _____
9. Place of practice: _____________________________________
10. Date & year of joining the profession: ________________
11. Admission fee Rs.________ Rs.300/-
1,500/- + Annual subscription_________+Welfare Rs. 500/-
12. Fee paid by cash / cheque / D.D no._______________
13. Bank name & Branch: ______________________
I do hereby declare that I shall abide by the Rules & procedure of the
association and the information given above is true to the best of my
knowledge & belief.
Identified by (Member TBA) Signature of applicant
Name: - Sign. ________
Enrolment no.
FOR OFFICE USE ONLY

Form No. TBA No. ______________

Application accepted / rejected and subscription & admission fee paid through
Money Receipt no.______________

GENERAL SECRETARY TREASURER

Ground floor, Central Revenue Building (Annexe), Bir Chand Patel Marg, Patna 800001