1965-HKRS30-8-56_Part04 — Page 25

3.

(6) Stave

(60

abortly the

grounds relled

upon for

Lacing, defend-

Jag, Continuing

or being

party to the

(7) ON: DANCI

wood podnesu),

(3) Ec

cluses it polla be

14 your ow

I

DO

Mupply add-

poedble. Th

TECH should show

hơn bar gh

PRETEK ÇATI,

from ba

knowledg at

The fact

conßrm poo

Dan Bement.

(9) You

should supply

with this

16

The grounds of my application are-

4.

The following persons can give evidence in support of my case-

and

5. I attach with this form the following documents-

קנין

FOTEN 13

(och a lettere.

comuneck,

deech, so ple

of will. x.)

which are

relevant to

FOOT CARE, And

supply a U

OF ALAD docu-

como the

source provided Jat,

mcrash the Bre

do a depoly deck of ULDET.

(10) If the

Director do

mot det for

FOO, POR KUN coiled to

velect You

own sollekter

And counsel,

If you do not

no refocu, cho

Dues hig

welcher or

៥. The solicitor and counsel (if counsel is assigned) whom I wish to act for

me in the proceedings are (10)

7. I understand that if my application is approved I shall be informed of the terms on which the Director is prepared to issue a Certificate, that those Condel for you. terms may include the payment by me of a contribution towards my costs of the proceedings, and I shill have the opportunity of accepting or refusing say offer of a certificate so made to me.

B I understand that I may be required by the Director to supply further

information in connexion with my application.

9. I have completed the statutory declaration herein.

Date

Signature of Applicant.

17

SPECIAL NOTICE TO APPLICANTS.

Section 23(1) of the Legal Aid Ordinance 1966 provides as follows-

"Any person seeking or receiving legal aid who-

(a) wilfully fails to comply with any regulations as to the information

to be supplied by him; or

(5) in furnishing any information required by such regulations know-

ingly makes any false statement or false representation, shall be guilty of an offence and Hable on summary conviction to a fine of five thousand dollars and to imprisonment for six mouths.".

STATUTORY DECLARATION BY APPLICANT,

1,00

of (6)

being the applicant in the within application do solemnly and sincerely declare that the replies to the undermentioned questions are true and correct to the best of my knowledge and belief.

A. State particulars and value of all properly of which you are possessed or to which you are entitled, exclusive of the sub- Peel matter of the proceedings referred to in the within application, your wearing apparel, your tools of trade, and the household furni- ture used by you in your home.

ALMANDPO

-FFFཋཱ"1╗ས *སྐ༈|1་" *

** P***PRAYNAKLANACEAEngadaka

(a) Name La £14.

(2) Addre jud decuplulehti,

M

INCIUDA

lund, banquey

and other boldoen. dodržkách, Enca In bound or in broka. bubd.

Ing Beeleden

* Diber

Bel

сать тонне

lowed to or bald by Boy mber period; IOIDES DE J

dus from wAT person be

estave or SET Flipeu. Bol 154 parable under ang will. tram, Belli-

E 42: the

present valore

od may fe

WIDER KALTAMOS

policy abuseEN

PROT, bonda

of any body codile, Borsel,

Tehicle

BICHON OV, of

poods ar

chattal of

Buy Had

WoRoever. DO NOT INCLUDE che awelln

house in widel you bedde. Particulkan ot that should be piven under Periph C betare.