7. FNPF No:

For official use only RR No: Amount: Date:

The Office of the Chief Regis t r arLegal Practitioners Unit

Phone: 3211481 Fax: 3300674 Email: 3211798 3313385 3211379

Website:

fijilegalunit@gmail.com

www.judiciary.gov.fj

APPLICATION FOR A PRACTISING CERTIFICATE(Pursuant to section 42 of the Legal Practitioners Act 2009) For the Period - 1st March 2019 to 29th February 2020

Part A: Personal Details of the Applicant

1. Surname:

2. Date of Birth: 3. Gender: Male Female Please Tick

4. Marital Status: Single Married Divorced Separated

5. T.I.N: 6. EDP No: If Employed by Government

8. Residential Address: 9. Postal Address:

10. Telephone Contact: 11. Mobile Contact:

12. Fax Contact: 13. Email address:

14. Next of Kin:Name:Relationship to you:Address:

Telephone contact in Fiji

15. Emergency Contact:Name:Relationship to you:Address:

Telephone contact in Fiji:

Passport Number: 16. Are You A Fiji Citizen? Yes No If No, do you possess a work permit? Yes No Please submit a copy if yes

17. Do you hold dual citizenship? Yes No If yes, please list passports held: [Passports held]

Country: _________________ No: ___________________ Address: Country: __________________ No: _____________________ Address: Country: ___________________ No: _____________________ Address:

18. Date of Admission in Fiji: 19. Category fees payable: Refer Schedule 1 20. Are you admitted in any other jurisdiction(s)?Yes No

Jurisdiction Date of admission Type of Practising Date last Practising Certificate Practising Certificate still

Certificate expired current Yes No Yes No Yes No

21. Do you have10 CLE points? Yes No

Middle Name: First Name:

26. Details About the Organization: Sole Trader Partnership Company Other:

Part B:Practice/Employment Details22. Name of Organization: 23. Position: 24. Date commenced current position: 25. Organization’s T.I.N

27. If Sole Trader; a) Name of Proprietor:b) Date of Registration of business: Please provide a copy of the Certi�icate of Registration c) Does the organization have a business license? Yes No Please provide copy

28. If Partnership; Please use additional sheets if insufficient space a) Name of Partner(s):(1) ________________________ (2) _________________

(3) _______________________ (4) b) Date of Registration of business: Please provide a copy of the Certi�icate of Registration c) Does the organization have a business license? Yes No Please provide copy

29. If Company; a)Name of Director(s):(1) __________________________ (2)

(3) __________________________ (4) b) Date of incorporation: Please provide a copy of Certificate of Registrationc) Does the organization have a business license? Yes No Please provide a copy

30. In case of Other; a) Name of contact person:b) Does the organization have a business license? Yes No Please provide a copy

31. Telephone Contact: Fax Contact: Email[s]:

Website:

Usual Place of Business: Postal Address:

32. Does the organization have a Branch office?Yes No

Details about the Branch Office: Name of Legal Practitioner based at the Office:

Telephone Contact: Fax Contact: Email[s]:

Place of Business Postal Address Website

Does the branch office have a business license? Yes No Please provide copy

33. Name & Address of City Agents

Go to No.31

Go to No.31

Go to No.31

Go to No.31

In case of Other, please indicate the nature

Part C: All Trust Account Details34. Name of Organization: Name of Auditor:

Name of Account Holder: _____________________________________ Bank: Account No: ______________________________________ Signatory(ies) (1) ________________________ Currency of Account: ______________________________________ (2)

(3) Name of Account Holder: ______________________________________ Bank: Account No: ______________________________________ Signatory(ies) (1) Currency of Account: ______________________________________ (2)

(3)_________________________

Name of Account Holder: ______________________________________ Bank: Account No: ______________________________________ Signatory(ies) (1) Currency of Account: ______________________________________ (2)

(3)

Name of Account Holder: ______________________________________ Bank: Account No: _______________________________________ Signatory(ies) (1) Currency of Account: _______________________________________ (2)

(3) ________________________

Name of Account Holder: _______________________________________ Bank: Account No: _______________________________________ Signatory(ies) (1) Currency of Account: ________________________________________ (2)

(3) _______________________

Part D:Statements on personal CharacterHave you ever: Yes No

a Been convicted of a crime or offence (including a conviction which is now removed from official record) before or since the date of your admission in Fiji or elsewhere?

b Been charged with any offence that is currently awaiting legal action?

c Been refused admission or struck off the roll of barristers andor/solicitors and/or legal practitioners in Fiji or elsewhere?

d Been refused a practising certificate, had it suspended orcancelled in Fiji or elsewhere?

e Been found guilty of professional misconduct in Fiji or elsewhere?

f Been found guilty of unsatisfactory professional conduct in Fiji orelsewhere?

If your answer is YES to any of the above questions, please provide all relevant details on a separate sheet.

35

Part E: Health & Fitness to Practice Law

36 (i) Have you a medical condition [mental or physical] which might affect your ability to give full or sufficient attention to your work as a practitioner or which might lead to being absent from work?

[If so, please provide details of your condition and attach relevant medical report(s).]

(ii) Have you any addictive, psychiatric or behavioral conditions to be revealed?

[If so, please provide details of your condition and attach relevant medical report(s).] 37

(i) Have you ever been adjudicated bankrupt in any jurisdiction? [If so, please provide details]

(ii) Do you remain an undischarged bankrupt? [If so, please provide details.]

(iii) Have you ever had a receiving order made against you or consented to orders against you in bankruptcy proceedings or committed an act of bankruptcy? If so, give details.

STATUTORY DECLARATION

I

of

And make this solemn declaration believing the same to be true and by virtue of

the Statutory Declarations Act, 1970.

DECLARED at ______________ this _____ day

of __________________________ , 2019

before me and I certify that the

declaration was read over in the

______________language to the declarant

who appeared fully to understand the

meaning thereof.

__________________________________

(Office held or nature of Appointment)

GUIDE TO THE FORM

GENERAL INFORMATION

Please read this guide carefully before you complete the application form.

1. Kindly answer all the questions. If a question does not apply toyou, state “Not applicable” or “NA”. Answer all Yes and No questions

2. Please provide as much information as possible. Incompleteapplications will not be considered until all the required information anddocumentation has been received.

3. All trustees of the trust accounts of a practice must ensure that their Trust Account auditor’s report and Trustee(s) Report have been submitted to the Chief Registrar prior to the 30th of November, 2018.

4. Where applicants have previously submitted attachments providing Confirmatory evidence e.g. admission in Fiji or Overseas, they need not submit the same documentary evidence at each renewal application for a Practising Certificate.

5. Please provide a duly executed Statutory Declaration stating thefollowing - “I have provided all true and accurate information in myPractising Certificate application form for the period 1st March 2019 to29th February 2020.”

6. Material non-disclosure or misrepresentation in this form may result in the cancellation of the Practising Certificate pursuant to section 42(10) of the Legal Practitioners Act of 2009.

7. If you have changed your name or the name on your Certificate for Admission, please supply certified copies of official documentation, e.g. Deed Poll documentation or Marriage Certificate.

8. Applicants are to submit to the Chief Registrar’s Office a recent passport size photo, a business card, letterhead of the firm/office they are currently employed in. The passport photo must be signed at the back and dated by the Applicant.

9. Applicants need to submit evidence of 10 Continuing Legal Education(CLE) points and the Board of Legal Education’ approval foraccreditation of the courses attended.

10. Holders of work permits must attach a copy of their permit to thisapplication.

11. If you have any questions, contact the Legal Practitioners Unit at fijilegalunit@gmail.com or phone 3211798/3211886.

Schedule of Fees

Category Fees($) A Practitioner with not more than 3 years practising

experience [excluding practitioners employed by Government Departments or statutory authorities]

350

B Practitioner currently unemployed 250

C Practitioner employed by Government departments or statutory authority irrespective of years of experience post admission

350

D Private Practitioners with not less than 3 years but not more than 5 years practicing experience

400

E Private Practitioner with more than 5 years of practicing experience

450

F Sole Practitioner in practice for not more than 3 years since commencement of practice

450

G

500

H Sole Practitioner or consultant practitioner in practice for more than 5 years since commencement of practice

550

I Practitioners employed by a private or publicly listed limited liability company or corporate body or bank (local or foreign based) or non-governmental

550

J 700

NB: Practitioners applying mid year (1st September 2019)will be charged fees for the Practising Certificate on a pro rata basis.

Sole Practitioner in practice for not less than 3 years but not more than 5 years since commencement of practice

organization, (local, regional, international) includingpractitioners employed by universities or tertiaryinstitutions

K

Equity, salaried, profit sharing or any other form ofpartner in a private firmPrivate practitioner operating a law firm abroad oremployed by a law firm abroad or employed by agovernment department or a statuory authority abroad

800

CHECKLIST

• Statutory Declaration (please refer to Guide No. 5)

• Current work permits, if applicable

• Certificat for enrolment/admission for Fiji (certified copy)-only provide if notsubmitted previously

• Certificate for enrolment/admission for overseas enrolments/admission (certified copy)-only provide if not submitted previously

• Certificates of attendance at approved courses, lectures, conference,

workshop [for CLE purposes] and evidence of approval by the Board of

Legal Education for such attendance unless previously forwarded to the

Chief Registrar

• Recent passport size photograph of Applicant [signed at back and

dated]

• Business Card

• Letterhead

• Business License of all branches

• Certificate of Registration, if applicable

• Copies of LLB/PDLP certificates (certified copy)-only provide if not submittedpreviously

• FNPF clearance (if applicable)

• Tax Compliance Certificate

• Provide a list of complaints (with name and ref. no.) against you or your lawfirm that you are aware of

Please ensure to provide all relevant documents

Applicants who are non Fiji citizens shall provide a valid work permit (if applicable)