CONSENT FOR SETTLEMENT OF CASES THROUGH SPECIAL LOK ADALAT

TO BE HELD BY HON’BLE SUPREME COURT OF INDIA

I___________________________________________S/o/D/o___________________________________, is
Petitioner/Respondent/ Party________________ having Case No. _____________________, in the Hon’ble
Supreme Court of India and the case is pending. I hereby give consent and I agree to participate for
settlement of my case through Special Lok Adalat scheduled to be held in the Hon’ble Supreme Court of
India from 29th July, 2024 to 3rd August, 2024, so as to get my case amicably settled as early as possible.
The details of cases are:

1. Case Number :
2. Name of Petitioner (s) :
(Along with Mobile Number
and E-mail ID)
3. Name of Respondents (s) :
(Along with Mobile Number
and E-mail ID)
4. Name of the Advocate for Petitioner(s) :
(Along with Mobile Number
and E-mail ID)
5. Name of the Advocate for Respondents (s) :
(Along with Mobile Number
and E-mail ID)

Signature of the Petitioner (s) with Date Signature of the Respondent (s) with Date
(Name in Block letters) (Name in Block letters)
_________________________ ________________________________
_________________________ ________________________________
Signature of the Advocate with date Signature of the Advocate with date
(Name in Block letters) (Name in Block letters)
_________________________ ________________________________
_________________________ ________________________________

DLSA, Central_II
E-Mail Address
rouseavenue-dlsa@delhi.gov.in
If any query please contact

8800168888
9958005088
9810978565
9818625084