Penrith Lawyers
Level 1, 331 High Street
Penrith, NSW, 2750
reception@penrithlawyers.net.au
www.penrithlawyers.net.au
(02) 4761 2974
Agency mention Booking form - Weekly
For Penrith Local and District Courts (only)
We are available to appear as agent on date/s:
Available days for period 20 March - 26 March 2023 (only):
*
Available days for period 27 March - 02 April 2023 (only):
*
Firm/Solicitor booking Agency Mention:
Firm Name (if applicable):
Name of Contact Person:
*
First Name
Last Name
Contact Person mobile number:
*
Please enter a valid mobile number.
Format: 0000-000-000.
Contact Person email address:
*
The result will be emailed to this email address.
Details of matter to be mentioned:
Documents can be uploaded below (Case Conference Certificates, Form 1s, etc)
Client name:
*
First Name
Last Name
Client mobile number: (if required)
Format: 0000-000-000.
If remanded, Correctional Centre Name:
If known.
Case Number (from Court List)
H Number
Instructions: (enter, type or upload)
Instructions must be entered or booking will not be accepted.
Type of matter to be mentioned:
*
Criminal
AVO
Both (single fee applies)
Court at Penrith
District
Local
Matter is listed for:
Mention
Charge Certification Mention
Case Conference Mention
Other
Is Client required to appear in Court?
No
Yes
Other
I/We seek the following orders:
Enter, type or upload as required.
Adjourn for:
Mention, Charge Certification, etc
Adjourn to date:
/
Day
/
Month
Year
Typed instructions: (optional)
Orders for Bail:
Please Select
No bail
Bail to continue
Bail refused
Not applicable
Upload a copy of relevant documents and/or instructions: (optional)
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of
Fees, terms and conditions:
Select the "applicable fee":
*
$198.00 (inc GST) - Legal Aid Funded
$220.00 (inc GST) - Privately Funded
Other - By prior agreement
Date/time booking was made:
*
/
Day
/
Month
Year
Minutes
AM
PM
AM/PM Option
Signature of Contact Person
*
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*
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