Application Acknowledgment Slip Application Details- ClientsDate Application Received(Required) DD dash MM dash YYYY Type of ID Used ID Card No. Client ID (CCMS Only) Title(Required) Mr Ms Date of Birth(Required) DD slash MM slash YYYY Enter full name(Required) Residential Address(Required) Street Address City/Town Postal Address Contact NumberOffice Application Received(Required)S01- 41 Loftus Street, Legal Aid BuildingS02- 16 Kimberly StreetS03- 73 Gordon StreetS05- Nasinu- Valelevu Complex Ground FloorS05/2 Nasinu- Valelevu Complex Level 1S06- Nausori Level 1 YM Haniff ArcadeS07- Korovou Waimaro Ciricuit Society BuildingS08- Navua Ro Matanitobua ComplexS09- Sigatoka Level 1, Magistrate’s Court ComplexS10- Nadi 1st Floor, Units 10-13 GT PlazaS11- Lautoka Level 1, Magistrate’s Court Complex Tavewa AvenueS11/2- Lautoka Marine DriveS12- Ba Magistrate’s Court Complex Old Bridge RoadS13- Tavua 1st Floor, Dalpat Singh Building Opposite Tavua Magistrate Court Nasivi StreetS14- Rakiraki 1st Floor, Naidu Investments Limited Building Vaileka Sub Division Main StreetS15- Labasa Old Court House Building Jaduram StreetS16- Savusavu Level 1, Vunilagi House Main StreetS17- Seaqaqa 70, Seaqaqa TownshipS18- Nabouwalu Naulumatua HouseS19- Taveuni First Light Inn Building Ground FloorS20- Levuka Lomaiviti Holdings Building Beach StreetS21- KeiyasiS22- VunidawaS23- KadavuS24- RotumaType of Matter(Required)Family LawCriminal LawCivil LawWhere is the matter filed at?(Required) Court Other Organization Application yet to be filed Which court is your case in?(Required)TribunalFamily CourtMagistrates CourtHigh CourtCourt of AppealSupreme CourtWhere is the court?(Required)SuvaLautokaLabasaNasinuNausoriNavuaNadiBaRakirakiTavuaKorovouSigatokaLevukaSavusavuTaveuniKeiyasiRotumaVunidawaIsland CourtCourt Case Number(Required) Island Court Location(Required) Other Organization(Required)Court RegistryNLTBILTBHousingFRCSTitlesLands DepartmentDeeds OfficePlease specify?(Required) Official Use OnlyOfficer Name(Required) First Last Officer Designation(Required)Client Information OfficerLegal OfficerReceptionistRegistry OfficerOffice Contact(Required)Email(Required) Note Acknowledgment Stamp and Officer Sign-Off