Annexure 'E'

VAKALATNAMA

SUBMITTED BY AN AIDED PERSON UNDER THE PROVISIONS OF HARYANA STATE LEGAL SERVICES AUTHORITY RULES, 1996

In the Court of Sh./Smt./Ms. .........................................................................................................................................

Criminal/Civil/Appellate/Original Jurisdiction

Criminal Case/Appeal/Revision No. .....................................................of.....................................................................

..................................................................................................................... Appellant(s)/Petitioner(s)/Applicant(s)

VERSUS

............................................................................................................................................................... Respondent(s)

F.I.R. No. .................................................................................. Police Station ............................................................

Charge under section(s) ..............................................................................................................................................

Sentence ........................................................................................................................................................................

Case/Appeal/Revision from the order of Magistrate, ........................................................

I/ we .................................................................son/daughter/wife of Sh. .....................................................................

Caste ..................................... resident of ........................................................................, District ..................................

.now a prisoner in the Jail at .................................................. hereby authorise the District Legal Services Authority, ............................................................./ Sub-Divisional Legal Services Committee.............................. to appoint any advocate on my/our behalf to file a Case/Appeal/Revision/Misc. Petition in the above case and to act, plead and take all other steps in furtherance thereof.

 

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

Petitioner(s)/)/Applicant(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) ..............................................

Petitioner(s)/Applicant(s)Defendant(s)/Respondent(s). Dated....................................................

 


Attestation by the Superintendent of Jail

The above declaration has been made by ..................................................... Prisoner No. ................................ at present confined in the .......................................... Jail which is under my charge as Superintendent. The contents of the declaration have been read over to the prisoner who admits them to be correct.

Signatures & Stamp of Superintendent

.................................... Jail, ..................


(FOR OFFICE USE)

Mr./Mrs./Ms. ......................................................................., Advocate is appointed as Counsel for the above named appellant(s)/petitioner(s)/applicant(s)/respondent(s).

 

Secretary, Chairman,
District Legal Services Authority, Sub-Divisional Legal Services Committee
...............................................................

Appointment as Counsel for aided person on behalf of the District Legal Services Authority, ........................................... /Sub-Divisional Legal Services Committee, ............................. ...............is hereby accepted.

 

(...................................................................)

                                                    Advocate,

...................................................................

.................................................................