Legal Practice Board Amendment Rules (No. 2) 2005 - Printer's correction (WA)
| 1292 | GOVERNMENT GAZETTE, WA | 19 April 2005 |
JUSTICE
jul01
PRINTERS CORRECTION
Legal Practice Act 2003
Legal Practice Board Amendment
Rules (No. 2) 2005
An error occurred in the notice published under the above heading on page 1170 of
Government Gazette No. 56 dated 12 April 2005 and is corrected as follows.At page 1171 to 1173 delete the table "Application for practice certificate" and insert the following table—
Legal Practice Act 2003
s. 37, 38, 39
Legal Practice Board
on which practice Telephone certificate will lake details of intended (If not currently A1)1)IiCIflt Practice Application for practice certificate j Rules 2004 r. 44
For m
17
I
Name
Title Mr/Ms/Mrs/Miss/Dr/Other
QC / SC Date of appointment
Jurisdiction in which appointed
Residential address No & Street
Suburb
State
Postcode
Telephone
Fax
Mobile
-
- Place of practice
Street address No & Street-
practising. give Suburb
State Postcode
Postal address -
practice as at date
Fax
0 Not practising -
effect.)
Capacity in which practising
o Barrister
0 Sole practitioner
Practice name
o Equity Partner
0 Salaried Partner
Partnership name________________________________
U'
0 Legal partnership
0 Multi-disciplinary partnership
o Director or officer of incorporated legal practice
Name of corporation
ACNorARBN
o Employee
Name of employer
o Consultant
Name of employer_________________________________
o Corporate solicitor
Name of employer_________________________________
19 April 2005 GOVERNMENT GAZETTE, WA 1293
Admission Jurisdiction outside WA Admitted as (e.g. barrister, solicitor, attorney) Give details for each jurisdiction in which Date of admission// admitted If more space is required, use page 4
Jurisdiction Admitted as_____________________________________ Date of admission/I________
Jurisdiction Admitted as Date of admission
-
Trust account
I *d I do not receive trust moneys.
* Delete whichever If yes, trust account used by applicant
is not applicable Name of account
Give details for each Name of bank___________________________ trust account Branch address_______________________________________________ If more space is required, use page 4 BSB No. Account No.______________________ Date account opened
Auditor
Name_________________________________________ Firm/company________________________ Address
Professional I mN o" n / ani /am covered by my employer's
indemnity professional indemnity insurance in accordance with the insurance * Delete whichever Legal Practice Act 2003.
is not applicable I *have I have not complied with Law Mutual's requirements.
Complaints An order under the Legal Practice Act 2003 s. 177, 185 or 191
*has / has not* Delete ,s'hichever (or an equivalent section of the Legal Practitioners Act 1893)
is not applicable been made in relation to me.
If yes, made under section on
Fine 0 fined $ 0 no fine
O paid on _I_/20 . _ 0 not paid
Costs 0 ordered to pay $ 0 no order O paid on _/_/20 0 not paid Expenses 0 ordered to pay $ 0 no order O paid on _/_/20__ 0 not paid
Fitness, I *n / am not an insolvent under administration within the
capacity and dq meaning of the Corporations Act (this includes being bankrupt).
solvency I 'am / am not a legal practitioner director of an incorporated
* Delete whichever legal practice that is insolvent within the meaning of the is not applicable Corporations Act. I If yes, give details
If more space is
required, use page 4
I *am / am not in prison. If yes, give details________________________________________
| I 291 | GOVERNMENT GAZETTE, WA | 19 April 2005 |
_
PaN ment Payment to accompany application
Practice certificate fee $ Guarantee Fund contribution $ (Contribution No. ) Total $ Method of payment
0 Cheque 0 Cash 0 Electronic funds transfer 0 Credit Card Name on card Card No. — — — — — — — — — — — — — — — —
Expiry date /20 Card holder's signature
Confirmation I confirm that —
• I am not struck off, suspended, disqualified or otherwise prohibited from engaging in legal practice in WA or in any other place; and • the information given in or with this application is true and correct and that I have not omitted any relevant information. Signature
Date / /20 .tdditional
information if
required
0
0
0