CLAS Form No.

001

COMMUNITY LEGAL AID SERVICE (CLAS) COMPLIANCE REPORT

1. Name:
2. Residential Address:
3. Office Address:
4. E-mail Address:
5. Bar Admission Roll No:
6. IBP Chapter: IBP No:
7. COMPLIANCE SUMMARY – Attached are the following documents:
a) CLAS Time Record (Annex A)
b) Certificate of Attendance (Annex B)

I hereby affirm that the above information is accurate and complete to the best of
my knowledge.

Printed Name and Signature Date