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Annexure-A

Applicotion (Proformar for the oost of Other

Person nber- Permonent Lok Adolots
(Established under section, 22-B of the Legal seruices Authorities Act, l9g7)
(To be filled personally by the applicont)

L.

Name:

(Capital Letters)
Self attested

2.

Father's/H usband's Name:

3.

Present Address:

4.

Permanent Address:

5.

6.

7.

8.

9.

11. Any other special qualification/achievement:

photograph

12. Present Employment, if any, :..........................................................................

(if yes, submit No Objection Certificate)

13. Details of Property: .........................................................................................

(To be submitted by the candidates, finally selected, before the joining)

14. Details of Family Members : ...

15. Contact No. :..
16. Email ID :
Date:
Place:

Signature of applicant

Note: Applicants are advised to exercise due diligence in filling the applications
as the DSLSA reserves the right to accept any additional/amended/revised
application.