FORM C CERTIFICATE OF ELIGIBILITY [SEE REGULATION. 39 (1)] THE ASSAM STATE LEGAL SERVICES AUTHORITY / HIGH COURT LEGAL SERVICES COMMITTEE /.............. DISTRICT LEGAL SERVICES AUTHORITY /................ TALUK LEGAL SERVICES COMMITTEE With reference to the application dated the ............20...... this is to certify that Shri / Shrimati...................... son / daughter / wife of.............., residing at ............. is entitled to receive legal aid / advice in respect of the legal proceeding, particulars whereof are given below :- (a) Name of the Court / Tribunal / Authority :- (b) Number and description of the legal proceeding :- (a)Name and address of the opponent :- (b)Extent of legal aid or the nature of the legal advice to be given:- (c)Other relevant particulars :- Date. Member-Secretary / Secretary Place. ..........Authority / committee
