FORMULIR KONSULTASI HUKUM

I. DATA PEMOHON
Nama :.............................................................................................................
Tempat/tanggal lahir :.............................................................................................................
Agama :.............................................................................................................
Pendidikan :.............................................................................................................
Golongan darah :.............................................................................................................
Alamat/telp/HP :.............................................................................................................
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Pekerjaan :.............................................................................................................
Keterangan Miskin :.............................................................................................................
II. Pelaksanaan konsultasi hukum ( tanggal/bulan/tahun )
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III. Uraian singkat pokok masalah dan latar belakangnya
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IV. Nasehat yang diberikan konsultasi termasuk aspek yuridisnya
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V. Hasil akhir konsultasi
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 VI. Kesan konsultasi atas tingkat pengetahuan / kesadaran hokum pemohon
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VII. Pemohon / klien
Nama :.....................................................................................................................
Tandatangan :.....................................................................................................................

VIII. Konsultan hukum

Nama :.....................................................................................................................
Tandatangan :.....................................................................................................................

, ..............................................2024
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