Application For A Practising Certificate Renewal And Solicitor Membership Of The Law Society Of New South Wales - 2015-2016

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2015/16 Application for a
Practising Certificate Renewal and Solicitor Membership of
the Law Society of New South Wales
ABN: 98 696 304 966 ACN: 000 000 699
Form 001a (03-15)
A
Your details (as at 1 July 2015)
Law Society number:
(if known)
Use the Scale of Fees on
Full name:
page 8 to confirm payment
amount.
Date of NSW
admission (if known):
(dd/mm/yyyy)
Practising Certificate Fee
$
360.00
Certificate type:
Fidelity Fund Contribution
As per the Law Society’s records.
Conditions/Undertaking:
$
60.00
Practice Name(s)
or Employer:
Membership Fee
Practice address:
(inc $36.00 GST)
$
396.00
State
P/code
NSW
Total
NSW
Principal place of practice:
$
816.00
DX number and location:
or
Due date
(
)
Business phone number:
mobile
15 MAY 2015
Business email address:
Extensions of time are not available.
(
)
Business fax number:
Refer to pages 6 and 8 for further
Practice’s principal address
information on membership and fees.
(if different from above):
State
P/code
NSW
Residential address:
Office Use Only (receipt no.)
State
P/code
NSW
or
(
)
mobile
Personal telephone number:
Now go to page 2 to complete
B
Intent to renew
Section D.
1
Will you be renewing your practising certificate?
Yes
Go to Q2 below (Section C – Renewal details).
No
Go to Q12 on page 3 (Section E – Non-renewal).
STOP
C
Renewal details
2
How will the payment be made?
You can renew your practising
EFTPOS (payments are to be made
certificate online at
in person at the Law Society)
Cheque/Money Order (made payable to
pcrenewals.
the Law Society of NSW and stapled to the front of this page)
Credit Card
Loan company (what is the name of the loan company?)
Please note: send the original form to the Law Society
and a copy of the front page to the loan/finance company.
Page 1

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