FORM – 1

MEMORIAL

[Rule – 4(2)]

  1. Name of the applicant. ……………………………………………………
  2. Father’s/Husband’s Name ………………………………………………..
  3. Date of Birth ………………………………………………………………
  4. Whether SC/ST/OBC/General ……………………………………………
  5. Address(Residence)……………………………………………………….

Pin………………………Telephone ……………..Fax………….E-mail…………………..

Address(Office)……………………………………………………………………

Pin………………………Telephone ……………..Fax………….E-mail………………….

  1. Educational Qualification(Please attach attested photocopies)…………………………….
  2. Enrolment number and date(Please attach attested photocopies)…………………………..
  3. Practising in                                         ……………………………………

Civil Side                              …………………………………….

Criminal Side                            …………………………………….

Taxation                                  …………………………………….

Revenue Courts                          ……………………………………

  1. Whether income tax assessee             ……………………………………
  2. The memorial of ( Name of the Applicant in Block Letters) showeth……………………..

1)      That the memorialist is a person eligible for appointment as a notary under the Notaries Act, 1952 and clause (a) of Rule 3 of the Notaries Rules, 1956.

2)      That the memorialist resides in ……………………. (here state the name of the local area or name of court where he intends to practice) and will reside for upwards of …………………… (state how long).

3)      That the number of notaries practicing in the local area is insufficient of the requirements thereof (the grounds of the statement should be added)

4)      That no previous application of the memorialist has been rejected or withdrawn by him, within the preceding six months.

The memorialist, therefore, prays that government be pleased to appoint and admit him as a

notary under and by virtue of the Notaries Act, 1952 (53 of 1952) and clause (a) of Rule 3 of the Notaries Rules, 1956 to practice in …………………………………………………….(here state the name of the local area).

 

Dated ……………day of ………………..20                    Signature of Applicant

 

Name and address of signatories

Profession

Name and address of the firm / Organisation

Signature with seal

1.

 

 

 

 

2.

 

 

 

 

3.

 

 

 

 

4.

 

 

 

 

5.

 

 

 

 

Note:- Under Rule 4(3) the memorial should be countersigned by a Magistrate, a Manager of Nationalized Bank, a merchant and two prominent inhabitants of the area where he intends to practise a Notary.