Local Bar Name and Membership No (required)

Enrolment Number of Advocate in State Bar Council with the Year of Enrolment

Certificate of Practice Details, Issued After Clearance of AIBE, Wherever Applicable

Name of Advocate [to be printed in short on cause list

Full Name of Advocate

Name of Advocate in Local Language

Date of Birth of Advocate

Gender of Advocate SelectM-MaleF-FemaleT-Transgender

Address of Advocate

Address of Advocate in Local Language

Email of Advocate(required)

Mobile Number of Advocate

Whatsapp [if any]

Phone Number of Advocate

Fax Number

Office Address of Advocate Where He / She Practices

Pin Code

District

Taluk

Office Address of Advocate in Local Language

Type of AdvocateSelectIndividual – 1Firm – 2Company – 3

If Firm or Company, Registration No. in BCI