Circular No 001 2017 LW

Circular No 001/2017/LW
Dated 19 Apr 2017

To Yayasan Bantuan Guaman Kebangsaan (“YBGK”) lawyers
Updated YBGK Interview Sheets and Claim Forms (With Effect from 1 May 2017)
We refer to YBGK Circular No 006/2016/LW dated 29 Nov 2016, entitled “Updated YBGK
Interview Sheets and Claim Forms (with Effect from 1 Dec 2016)”, which is attached for your
reference.
We subsequently received feedback from YBGK lawyers and the Bar Council Legal Aid Centres
(“LACs”), proposing amendments to the documents. The proposals were discussed at a National
Legal Aid Committee meeting, and the changes that are necessary have been made to the
interview sheets and claim forms.
Please use these updated documents, which are attached as individual Word documents, for all
claims submitted from 1 May 2017 (Monday) onwards:
(1) Arrest Interview Sheet — A1 (a) and A1 (b);
(2) Remand Interview Sheet — A2;
(3) Bail Interview Sheet — A3;
(4) Mitigation Interview Sheet — A4 (a) and A4 (b);
(5) Travel and Miscellaneous Claim Form — B1;
(6) Arrest and Remand Claim Form — B2;
(7) Bail and Mitigation Claim Form — B3;
(8) Trial Claim Form — B4 (a) and B4 (b); and
(9) Appeal Claim Form — B5 (a) and B5 (b).
For your convenience, the nine documents have been consolidated and are also attached as a
single document in PDF format.
Please take note that these interview sheets and claim forms are to be used with effect from 1
May 2017 (Monday). In order to ensure that the updated documents are used, kindly discard all
previous versions. Any claims submitted after 1 May 2017 using the old documents will not be
in compliance, and will be rejected by the Bar Council LACs.
Use of the updated documents will standardise the forms submitted by all YBGK lawyers, and
will help expedite the claims process.
YBGK Circular No 007/2016/LW dated 29 Nov 2016, entitled “Guidelines on Making Claims for
YBGK Work” is also attached for your reference.
If you have any questions or require any clarification in respect of this circular, kindly contact the
Bar Council YBGK Secretariat by telephone at 016-343 5202 (Stephanie Bastian) or 03-2072
2050 (Sumitra Veeriah), or by email to sumitra@kllac.com. Alternatively, you may also contact
your State LAC.
Thank you.
Ravi Nekoo
Chairperson
Bar Council YBGK Steering Committee
[A1(a)/1/5/17]
YAYASAN BANTUAN GUAMAN KEBANGSAAN

(BAR COUNCIL YBGK SECRETARIAT)
ARREST INTERVIEW SHEET
Date: ………………………………. Time of Arrest: ………………..

_____________________________________________________________________________________________
PART A. Details of Suspect
Name: ....................................................................................... Male ⁮ Female
IC. No: .....................................................................................
Address:.........................................................………………………………....................................................................
………………………………………………................................................…………………………………………...
Age: .................... Held (Police Station): ............................... Contact No: ………………….………....
PART B. Details of Family/Friend (must be above 18 – preferably someone who can be a Bailor)
Name: ………………………………………….................... Relationship: ………………………………………
Address: Same as above: New Address: ………………………………………………………………………
……..............................................................................…………………………………………………………………
Contact No: ................…………………....... Can he/she post bail? Yes No ⁮
PART C: DETAILS OF ARREST:

Place of Arrest
1. Time of Arrest (try to be accurate)?............................. 2.Where were you arrested? ...................................
2. Did you resist arrest? Yes No
3. Did the Police Officer inform you why you were being arrested? Yes No
- If no, do you know why you were arrested? ......................................................................................................
Details of Complainant (only in cases where the complainant is NOT the Police or Enforcement Agency)
Do you know the Complainant? Yes No:
1. If yes , relationship with the complainant? ……………………………………
a) Is this the first time you have had a problem with the complainant? Yes No
Questioning by police
1. Have the police taken a statement from you? Yes No - If yes, what time?............................
(explain to the client that this would be the 112 statement which he would have had to sign and confirm)
2. Did the police A) inform you have a right to See a Lawyer before the statement was taken? Yes: No:
B) Inform you that you need not answer questions that will incriminate you? Yes: No:
C) read back to you the statement before you signed it? Yes: No:
D) Allow you to contact a family member/friend Yes: No:
Investigation done by the police

1. As far as you know, what other investigative steps have the Police taken? (for example)
Kawad cam? Recovered “Barang Kes” Interviewed witnesses Taken bodily fluid specimens
Others: ………………………………………………………………………………………………………………
[A1(b)/1/5/17]
Previous Convictions:
1. Do you have any previous convictions? Yes No If yes, how many?...........................
2. How many consecutive days have you been in detention (for this offence or any other offence)?....................
Treatment at the police station
1. Have you been assaulted by anyone since your detention? Yes No
2. If yes, by whom?.........................................................................
Special needs
Do you have any special needs/requests? Yes No If yes,what? ……………………………..
Financial, Social status of the arrested person
1. Where do you work? ..................................................................................................
If Own Business If Employed:
How long have you run this business? ........................ How long have you worked there?..........................
How many employees do you have? ........................... Family business? Yes: No:
If yes, relationship with your employer?..................
Marital Status
1. Single Married Divorced Do you have children? Yes No
2. Do you have any dependents? Yes No: If yes, who?......................................................
3. Who do you live with? ......................................................................................................................................
PART D. DETAILS OF CHARGE
1. Charge Section:………………………………………………………………..................................................
2. Who arrested you: POLICE RELA MACC Others: ………………………………..……..
PART E. FACTS OF CASE & ADVICE GIVEN
1. Facts:
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
2. Advice Given:
………………………………….......................................................................................................................................
...........................................................................................................................................................................................
Details of Lawyer:
a) Name :
b) Firm :
c) Signature :
[A2/1/5/17]

REMAND INTERVIEW SHEET
Date : …………………………
OYDS Name: ………………………………………....
Consecutive days in
IC No : ................................................................ Detention:…….………
Sex: M / F Age: .................... Special Circumstances (if any):

Police Station of Arrest: ..........................................................
……………………………………….……
Court Coram:
Financial, Social status of the arrested person …………
Magistrate:
……………………………………………
1. Working? Y / N 2. If Yes, Self Employed / Employed by someone
…………………………………….
3. Working at this job for how long ? ………………………………………
4. If not working : Why? …………………………………………………… IO: …………………………………..……
Special needs
Days Granted: …………………
Does OYDS have any special needs/requests? Y / N If yes, pls state: ……
Marital Status Next date: .…..…/….……..
Single Married Divorced Children? Y / N
Court’s
Who are the OYDS Dependants (If any)?...................................................... Instructions::…….…………………..
……………………………………………
Details of Family/Friend (must be above 18)
Name: ………………………………………….................... …….
Relationship: …………………………...……......................
Contact No: ...........…………………....... ⁮
DETAILS OF ARREST & OFFENCE:
OTHER OFFENCE DRUG ABUSE/CONSUMPTION

OFFENCE
Place of Arrest
1. Time of Arrest (try to be accurate)? ............................ 2.Where were you arrested? ............................................
3. Does OYDS know why he was arrested? .........................................................................(Section :........................)
1. Have the police taken a statement from him? Yes No - If yes, what time? ............................
Investigation done by the police Police taken a sample (urine) from OYDS? Y / N
1. As far as OYDS knows, what other investigative steps have the If yes: When?
Police taken? (for example) If urine test taken, does he know the results?
Kawad cam? Recovered “Barang Kes” Positive Negative
Interviewed witnesses Others: ………………………………… Don’t know
1. Does OYDS have any previous convictions? Yes No
FACTS OF CASE
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
Details of Lawyer
Name :
Firm :
Signature :
[A3/1/5/17]
BAIL INTERVIEW SHEET
Date: ………………….
Court No: Magistrate:
PARTICULARS OF ACCUSED
1) Name : ………………………………………………………………………………..
2) IC No : ………………………………………………………………………………..
3) Sex :M/F
4) Age : ………………………………………………………………………………..
5) Marital Status : ………………………………………………………………………………..
6) Contact No : ………………………………………………………………………………..
7) Date of Arrest : ………………………………………………………………………………..
8) Case No : ………………………………………………………………………………..
9) Charge : Section ________________________
PARTICULARS OF SURETY/S
1st Surety 2nd Surety

Name
Parents Parents
Siblings Siblings
Relationship with accused
Employer Employer
Friend Friend
Contact No
Bail application details/comments:

__________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________
Bail Amount Granted: RM
Conditions of Bail : ……………………………………………………………………………...
Details of Lawyer:
Name :
Firm :
Signature :
[A4(a)/1/5/17]

MITIGATION INTERVIEW SHEET
Date: ............................
Case No:
1) Name : ………………………………………………………………………
2) IC No : ………………………………………………………………………
3) Sex :M/F
4) Age : ………………………………………………………………………
5) Contact No : ………………………………………………………………………
6) Date of Arrest : ………………………………………………………………………
7) Remand : YES/NO Remanded Since: …………………
8) Charge : Section (s) :
MITIGATION FACTORS
1) Education : ……………………………………………………
2) Occupation : ……………………………………………………
3) Role of Accused : ……………………………………………………
4) Did Accused gain from crime : ……………………………………………………
5) Influence of external circumstance : ……………………………………………………
6) Victimless crime : ……………………………………………………
7) Special Circumstances : ……………………………………………………
8) Medical Condition : ……………………………………………………
9) Dependents : ……………………………………………………
[A4(b)/1/5/17]
YAYASAN BANTUAN GUAMAN

10) Marital Status : Single / Married / Divorce
11) No of children : ………………… Age: …………………
12) Sole Breadwinner : Yes/No
13) Family Background/ Circumstance : ……………………………………………………
14) Any previous conviction : Yes / No
If yes please state the previous convictions below:
…………………………………………………………………………………………………
Comments
_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Sentence passed by Court:
__________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
If custodial sentenced: Yes/No
Details of Lawyer
Name :
Firm :
Signature :
[B1/1/5/17]
TRAVEL & MISCELLANEOUS CLAIM FORM
Personal Details of Lawyers
Name
Firm
Address
*KINDLY SUBMIT GOOGLE MAPS FOR MILEAGE CLAIMS & ORIGINAL RECEIPTS FOR PUBLIC
TRANSPORT AND MISCELLANEOUS CLAIMS FAILING WHICH THE CLAIM WILL NOT BE APPROVED
1. Mileage Claim
Date From To Type of Work Distance Rate Amount
Total
2. Public Transport
Date From To Type of Work Mode of Transport Amount

(Taxi/Airplane/Bus/Train)
Total
B. Grand Total of Travel Claims: C. Miscellaneous Claims

Grand Total Of Travel Claim Items Total (RM)
(Milieage Claims and Public RM Parking
Transport) Toll Charges
Photocopy
(justify)
Court
Documents
(Justify)
Grand Total
I hereby declare that all particulars stated herein are true.
Details of Lawyer Stamped By

Name:
Firm:
Signature:
[B2/1/5/17]
ARREST & REMAND CLAIM FORM
PERSONAL DETAILS OF LAWYERS
Name :
Duty Date :
Duty Location :
A) PARTICULARS OF LEGAL CLAIMS

1st
Offence Remand
Gender Date of remand /
No. Client I.C. No. Arrest Remand Suspected days Amount
(M/F) arrest 2nd
of granted
remand
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
GRAND TOTAL RM

Claim Amount
Details of Lawyer Stamped By:
A. Claim for Arrest
Name: & Remand
Signature: B. Travel Claim
C. Miscellaneous
Claim
Grand Total Claim
[B3/1/5/17]
BAIL & MITIGATION CLAIM FORM
LAWYER’S DETAILS
Name
Duty Date
Court
Judicial Officer
A. Particulars of Legal Claim
Name of OKT: Name of OKT:

I/C Number: I/C Number:
Court: Gender: M/F Court: Gender: M/F
Case Number : Case Number :
Section Charged Section Charged
Mitigation /Bail : Mitigation /Bail :
Remarks : Remarks :
Amount Amount
Remarks : Remarks :
Amount Amount
Remarks : Remarks :
Amount Amount
Grand total for Bail &Mitigation (RM)
I hereby declare that all particulars stated herein are true:

Claim Amount
A. Claim for Bail &
Details of Lawyer: Stamped By: Mitigation
B. Travel Claim
Name :
Signature: C. Miscellaneous
Claim
Grand Total Claim
[B4(a)/1/5/17]
YAYASAN BANTUAN GUAMAN KEBANGSAAN Claim Amount
A. Trial Claim
TRIAL CLAIM FORM
B. Travel Claim
C. Miscellaneous
Date of Submission of Claims: …………………………..
Claim
A. Lawyers Details Grand Total Claim
Name Bank Name

BC No Account Number
IC Number Mobile Number
Firm Name Office Phone Number
Address Email Address
B. Clients Details
Client’s Name Court

IC Number Criminal
Case
Number
YBGK File Number Offence
If client is jointly charged
please state the other clients
name & YBGK File Number
Outcome of Trial Acquittal & Discharge:
DNAA (Give Reasons):
Sentence :
C. If client changes plea and Pleads Guilty
Date of Change of Plea/Reasons Mitigating Factors Sentence

[B4(b)/1/5/17]

TRIAL CLAIM FORM
D) Particulars of Legal Claims for Criminal Files
 Please state the date , tick (√) on the work done & state the amount according to the payment schedule
 Please use additional sheet if this sheet is insufficient
Interview Hearing
Mention* and Plea Getting
(Prison/ Welfare Decision Closing
Date Case Bargain Up Mitigation Amount Remarks
Detention Report PP’s D’s (Mention) file fee
Management Cost
Centre Case case
TOTAL
*For more than 3 mentions, please give reasons
I hereby declare that all particulars stated herein are true
Details of Lawyer Stamped by:
Name:
Firm:
Signature:
YAYASAN BANTUAN GUAMAN KEBANGSAAN [B5(a)/1/5/17]
APPEAL CLAIM FORM
Claim Amount
Date of Submission of Claims: …………………… A.Claim for
Appeal
B.Travel Claim
A. Lawyers Details
C.Miscellaneous
Name Bank Name
Claim
BC No Account Number Grand Total
IC Number Mobile Number Claim
Firm’s Name Office Phone Number
Firm’s Email Address
Address
B. Clients Details

IC Number Appeal/Revision
Case Number
Type of Appeal Appeal against Conviction
Appeal against sentence
Outcome of Appeal/Revision
(Please attach court order)
[B5(b)/1/5/17]
APPEAL CLAIM FORM
C) Particulars of Legal Claims for Criminal Files

 Please include court order
Interview (Prison/
Date Mention Case Management Decision Closing file fee Amount
Detention Centre
TOTAL
Name:
Firm:
Signature:
Dated 29 Nov 2016
Updated YBGK Interview Sheets and Claim Forms (with Effect from 1 Dec 2016)
It has been brought to our attention that some YBGK lawyers are using outdated interview sheets and
claim forms.
In order to ensure that standard forms are used, kindly discard all previous forms. Please use these
updated documents, which are attached as individual Word documents:
(a) Arrest Interview Sheet — A1 (a) and A1 (b);

(b) Remand Interview Sheet — A2;
(c) Bail Interview Sheet — A3;
(d) Mitigation Interview Sheet — A4 (a) and A4 (b);
(e) Travel and Miscellaneous Claim Form — B1;
(f) Arrest and Remand Claim Form — B2;
(g) Bail and Mitigation Claim Form — B3;
(h) Trial Claim Form — B4 (a) and B4 (b); and
(i) Appeal Claim Form — B5 (a) and B5 (b).
For your convenience, the nine documents have also been consolidated, and are attached as a single
document in PDF format.
Please take note that these interview sheets and claim forms are to be used effective from 1 Dec 2016
(Thursday). Any claims submitted after 1 Dec 2016 using the old forms will not be in compliance,
and will be rejected by the Bar Council Legal Aid Centres (“LACs”).
If you have any questions or require any clarification in respect of this circular, kindly contact the Bar
Council YBGK Secretariat by telephone at 016-343 5202 (Stephanie Bastian) or 03-2072 2050
(Sumitra Veeriah), or by email to sumitra@kllac.com. Alternatively, you may also contact your State
LAC.
Thank you.
Ravi Nekoo
Chairperson
YAYASAN BANTUAN GUAMAN KEBANGSAAN A1 (a)
ARREST INTERVIEW SHEET
Date: ………………………………. Time of Arrest: ………………..

_____________________________________________________________________________________________
PART A. Details of Suspect
Name: ....................................................................................... Male Female
IC. No: .....................................................................................
Address:.........................................................………………………………....................................................................
………………………………………………................................................…………………………………………...
Age: .................... Held (Police Station): ............................... Contact No: ………………….………....
PART B. Details of Family/Friend (must be above 18 – preferably someone who can be a Bailor)
Name: ………………………………………….................... Relationship: ………………………………………
Address: Same as above: New Address: ………………………………………………………………………
……..............................................................................…………………………………………………………………
Contact No: ................…………………....... Can he/she post bail? Yes No
PART C: DETAILS OF ARREST:

Place of Arrest
1. Time of Arrest (try to be accurate)?............................. 2.Where were you arrested? ...................................
2. Did you resist arrest? Yes No
3. Did the Police Officer inform you why you were being arrested? Yes No
- If no, do you know why you were arrested? ......................................................................................................
Details of Complainant (only in cases where the complainant is NOT the Police or Enforcement Agency)
Do you know the Complainant? Yes No:
1. If yes , relationship with the complainant? ……………………………………
a) Is this the first time you have had a problem with the complainant? Yes No
1. Have the police taken a statement from you? Yes No - If yes, what time?............................
2. Did the police A) inform you have a right to See a Lawyer before the statement was taken? Yes: No:
B) Inform you that you need not answer questions that will incriminate you? Yes: No:
C) read back to you the statement before you signed it? Yes: No:
D) Allow you to contact a family member/friend Yes: No:
Investigation done by the police

1. As far as you know, what other investigative steps have the Police taken? (for example)
Kawad cam? Recovered “Barang Kes” Interviewed witnesses Taken bodily fluid specimens
Others: ………………………………………………………………………………………………………………
A1 (b)
1. Do you have any previous convictions? Yes No If yes, how many?...........................
2. How many consecutive days have you been in detention (for this offence or any other offence)?....................
Treatment at the police station
1. Have you been assaulted by anyone since your detention? Yes No
2. If yes, by whom?.........................................................................
Special needs
Do you have any special needs/requests? Yes No If yes,what? ……………………………..
1. Where do you work? ..................................................................................................
If Own Business If Employed:
How long have you run this business? ........................ How long have you worked there?..........................
How many employees do you have? ........................... Family business? Yes: No:
If yes, relationship with your employer?..................
Marital Status
1. Single Married Divorced Do you have children? Yes No
2. Do you have any dependents? Yes No: If yes, who?......................................................
3. Who do you live with? ......................................................................................................................................
PART D. DETAILS OF CHARGE
1. Charge Section:………………………………………………………………..................................................
2. Who arrested you: POLICE RELA MACC Others: ………………………………..……..
PART E. FACTS OF CASE & ADVICE GIVEN
1. Facts:
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
2. Advice Given:
………………………………….......................................................................................................................................
...........................................................................................................................................................................................
.................................................................................................................................................…………………………
Details of Lawyer:
a) Name :
b) Firm :
c) Signature :
A2
REMAND INTERVIEW SHEET
Date : …………………………
OYDS Name: ………………………………………....
Consecutive days in
IC No : ................................................................ Detention:…….………
Sex: M / F Age: .................... Special Circumstances (if any):

Police Station of Arrest: ..........................................................
Court Coram:
Magistrate:
1. Working? Y / N 2. If Yes, Self Employed / Employed by someone
…………………………………….
3. Working at this job for how long ? ………………………………………
4. If not working : Why? …………………………………………………… IO: …………………………………..……
Special needs
Does OYDS have any special needs/requests? Y / N If yes, pls state: …… Days Granted: …………………
Marital Status Next date: .…..…/….……..
Single Married Divorced Children? Y / N
Court’s
Who are the OYDS Dependants (If any)?...................................................... Instructions::…….…………………..
……………………………………………
Details of Family/Friend (must be above 18)
Name: …………………………………………....................
Relationship: …………………………...……......................
Contact No: ...........………………….......
DETAILS OF ARREST & OFFENCE:
OTHER OFFENCE DRUG ABUSE/CONSUMPTION

OFFENCE
Place of Arrest
1. Time of Arrest (try to be accurate)? ............................ 2.Where were you arrested? ............................................
3. Does OYDS know why he was arrested? .........................................................................(Section :........................)
1. Have the police taken a statement from him? Yes No - If yes, what time? ............................
Investigation done by the police Police taken a sample (urine) from OYDS? Y / N
1. As far as OYDS knows, what other investigative steps have the If yes: When?
Police taken? (for example) If urine test taken, does he know the results?
Kawad cam? Recovered “Barang Kes” Positive Negative
Interviewed witnesses Others: ………………………………… Don’t know
1. Does OYDS have any previous convictions? Yes No
FACTS OF CASE
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
Details of Lawyer
Name :
Firm :
Signature :
A3
BAIL INTERVIEW SHEET

Date: ………………….
1) Name : ………………………………………………………………………………..
2) IC No : ………………………………………………………………………………..
3) Sex :M/F
4) Age : ………………………………………………………………………………..
5) Marital Status : ………………………………………………………………………………..
6) Contact No : ………………………………………………………………………………..
7) Date of Arrest : ………………………………………………………………………………..
8) Case No : ………………………………………………………………………………..
9) Charge : Section _______________________________________________
PARTICULARS OF SURETY/S
1st Surety 2nd Surety

Name
IC No
Relationship with accused :
Contact No
Brief facts of the case & bail application details (*Please use additional sheet if necessary)
__________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Bail Amount
RM
Granted:
Conditions of Bail : ……………………………………………………………………………...
Details of Lawyer:
Name :
Firm :
Signature :
YAYASAN BANTUAN GUAMAN KEBANGSAAN A4(a)
Date: ............................
Court No : Magistrate:
1) Name : ………………………………………………………………………
2) IC No : ………………………………………………………………………
3) Sex :M/F
4) Age : ………………………………………………………………………
5) Contact No : ………………………………………………………………………
6) Date of Arrest : ………………………………………………………………………
7) Remand : YES/NO Remanded Since: …………………
8) Case No : ………………………………………………………………………
9) Charge : Section (s) :
10) Next of kin contact No : ………………………………………………………………………
MITIGATION FACTORS
1) Education : ……………………………………………………
2) Occupation : ……………………………………………………
3) Name & Place of employment : ……………………………………………………
4) Role of Accused : ……………………………………………………
5) Did Accused gain from crime : ……………………………………………………
6) Influence of external circumstance : ……………………………………………………
7) Victimless crime : ……………………………………………………
8) Special Circumstances : ……………………………………………………
9) Medical Condition : ……………………………………………………
10) Dependents : ……………………………………………………
Relationship Age
YAYASAN BANTUAN GUAMAN KEBANGSAAN A4(b)
11) Marital Status : Single / Married / Divorce
12) No of children : ………………… Age: …………………
13) Sole Breadwinner : Yes/No
If Accused NOT the sole breadwinner, kindly fill up the following questions
14) Total family expenditure per month : ……………………………………………………
15) Contribution to family : ……………………………………………………
16) Spouse’s Occupation : ……………………. Spouse’s Income: …………
17) Family Background/ Circumstance : ……………………………………………………
18) Any previous conviction : Yes / No

If yes please state the previous convictions below:
Date Section Punishment given
BRIEF FACTS OF THE CASE AND MITIGATION SUBMITTED

(*Please use additional sheet if necessary)
_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Sentence passed by Court:
__________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
Details of Lawyer
Name :
Firm :
Signature :
YAYASAN BANTUAN GUAMAN KEBANGSAAN B1
TRAVEL & MISCELLANEOUS CLAIM FORM
Date: ……………………………..
Personal Details of Lawyers
Name
Firm
Address
*KINDLY SUBMIT GOOGLE MAPS FOR MILEAGE CLAIMS & ORIGINAL RECEIPTS FOR PUBLIC
TRANSPORT AND MISCELLANEOUS CLAIMS FAILING WHICH THE CLAIM WILL NOT BE APPROVED
1. Mileage Claim
Date From To Type of Work Distance Rate Amount
Total
2. Public Transport
Date From To Type of Work Mode of Transport Amount

(Taxi/Airplane/Bus/Train)
Total
B. Grand Total of Travel Claims: C. Miscellaneous Claims

Mileage Claim RM Items Total (RM)
Public Transport RM Parking
Grand Total Of Travel Claim RM Toll Charges
Photocopy
(justify)
Court
Documents
(Justify)
I hereby declare that all particulars stated herein are true; Grand Total
Details of Lawyer Stamped By

Name:
Firm:
Signature:
B2
ARREST & REMAND CLAIM FORM
Date:
PERSONAL DETAILS OF LAWYERS
Name :
Duty Date :
Duty Location :

A) PARTICULARS OF LEGAL CLAIMS
No. Client I.C. No. Gender Date of Arrest Remand Offence Remand 1st Amount
(M/F) arrest Suspected days remand /
of granted 2nd
remand
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
GRAND TOTAL RM

Claim Amount
Details of Lawyer Stamped By:
A. Claim for Arrest
Name: & Remand
Signature: B. Travel Claim
Date :
C. Miscellaneous
Claim
Grand Total Claim
B3
BAIL & MITIGATION CLAIM FORM
Date: …………………..
LAWYER’S DETAILS
Name
Duty Date
Court
Judicial Officer
A. Particulars of Legal Claim
Name of OYDS: Name of OYDS:

Remarks : Remarks :

Amount Amount
Remarks : Remarks :

Amount Amount
Remarks : Remarks :

Amount Amount
Grand total for Bail &Mitigation (RM)
I hereby declare that all particulars stated herein are true:

Claim Amount
Details of Lawyer: Stamped By: A. Claim for Bail &
Mitigation
Name : B. Travel Claim
Signature:
Date : C. Miscellaneous
Claim
Grand Total Claim
YAYASAN BANTUAN GUAMAN KEBANGSAAN B4 (a)
Claim Amount
A. Trial Claim
TRIAL CLAIM FORM
B. Travel Claim
Date of Submission of Claims: ………………………….. C. Miscellaneous
Claim
A. Lawyers Details Grand Total Claim
Name Bank Name

BC No Account Number
IC Number Mobile Number
Firm Name Office Phone Number
Address Email Address
B. Clients Details

IC Number Criminal
Case
Number
Outcome of Trial Acquittal & Discharge:
DNAA (Give Reasons):
Sentence :
C. If client changes plea and Pleads Guilty
Date of Change of Plea/Reasons Mitigating Factors Sentence

B4(b)
(KUALA LUMPUR)
TRIAL CLAIM FORM
Date Interview Mention Pre- Case Plea Welfare Revision Getting Hearing Mitigation Decision Closing Amount
(Prison/ * Trial Management Bargain Report Up (Mention) file fee
Detention Conference Cost PP’s D’s
Centre Case case
TOTAL
*For more than 3 mentions, please give reasons
Name:
Firm:
Signature:
YAYASAN BANTUAN GUAMAN KEBANGSAAN B5 (a)
APPEAL CLAIM FORM
Claim Amount
Date of Submission of Claims: …………………… A.Claim for
Appeal
B.Travel Claim
A. Lawyers Details
C.Miscellaneous
Name Bank Name
Claim
BC No Account Number Grand Total
IC Number Mobile Number Claim
Firm’s Name Office Phone Number
Firm’s Email Address
Address
B. Clients Details

IC Number Appeal Case
Number
Type of Appeal Appeal against Conviction
Appeal against sentence
Outcome of Appeal
(Please attach court order)
B5 (b)
APPEAL CLAIM FORM

 Please include court order
Date Interview (Prison/ Mention Case Management Appeal Closing file fee Amount
Detention Centre
TOTAL
Name:
Firm:
Signature:
Dated 29 Nov 2016

Guidelines on Making Claims for YBGK Work
The following guidelines are to assist lawyers in making their claims for YGBK work.
I. General Guidelines on Making Claims
Below are guidelines that will assist the YBGK Headquarters in processing your claims:
(1) Please ensure that your handwriting is legible;
(2) Please mark the relevant columns clearly;
(3) Please ensure that your interview sheets and claim forms are completed;
(4) Please use the updated YBGK interview sheets and claim forms, which will come
into effect on 1 Dec 2016 (see YBGK Circular No 006/2016/LW, entitled “Updated
YBGK Interview Sheets and Claim Forms (with Effect from 1 Dec 2016)”, dated 29
Nov 2016);
(5) Please do not use recycled paper to photocopy your interview sheets and claim forms;
(6) Please ensure that your travel claims for mileage are attached with maps from
“Google Maps” (calculated from the location of your law firm);
(7) Please attach original receipts for your public transport and miscellaneous claims;
(8) Please ensure that your receipts are pasted on sheets of paper and attached to your
claims; and
(9) Please ensure that the calculations in your claim forms are correct.
Further, kindly take note of the following:
(1) Lawyers are not allowed to use the photocopier at the Legal Aid Centre (“LAC”) to
make copies of interview sheets or claim forms; and
(2) Lawyers are not allowed to claim for the cost of photocopying the interview sheets and
claim forms.
II. Guidelines on Making Claims for Specific Matters

Below are specific guidelines that will assist YBGK HQ in processing your claims:
A. Specific Guidelines on Making Claims for Arrest and Remand Duty
1. Interview Sheet
Please submit interview sheets together with your claims for arrest and remand.
2. Time of Arrest
Please ensure that your arrest interview sheets and claim forms state the time and
place of arrest.
3. Name and IC Number
Please ensure that claims made for arrest and remand duty contain the name and
identity card (“IC”) number of the Orang Yang Disyaki (“OYDS”, ie the suspect). If
there is no IC number, please provide an explanation.
4. Claims Made for Mileage but No Service Rendered

If a claim is made for mileage but no service was rendered, please provide an
explanation.
Eg: I was rostered for duty but when I went there, the police did not bring any OYDS
for remand.
B. Specific Guidelines on Making Claims for Bail and Mitigation
1. Case Number and Court

Please ensure that the case number and court number are stated in the claim forms.
2. Section 3 of the Drug Dependants (Treatment and Rehabilitation) Act 1983

(“Act”)
When making a claim for representation under section 3 of the Act, please consider it
as a remand application and follow the rate of payment for remand, not bail.
3. Making a Claim When Not Rostered for Duty

If you make a claim but you were not rostered for duty, please explain the reason(s)
why the claim is being made.
Eg: I was not on duty but because there were too many suspects brought to court, I
was asked by the State LAC to assist.
C. Specific Guidelines on Making Claims upon Completion of a Criminal Trial
1. More than Three Mention Dates

If there are more than three mention or case management dates, please provide an
explanation for those mention dates.
2. Discharge Not Amounting to Acquittal (“DNAA”)

If the court makes an order of DNAA, please give reasons for the DNAA.
Eg: Prosecution witness did not attend court.
3. Getting Up Fee for DNAA

If the DNAA was given by the court on the second day of trial, then you can claim
getting up fees. However you will not be entitled to getting up fees if the DNAA was
given on the first day of trial.
4. Getting Up Fees
If the Orang Kena Tuduh (“OKT”, ie the accused person) pleads guilty on the first
day of trial, you will not be entitled to getting up fees.
5. Outcome of Case
Please inform YBGK HQ of the outcome of the trial, ie whether the OKT was
acquitted or convicted, and if convicted, the sentence that was passed.
6. Welfare Report
If a claim is made for seeing the Welfare Officer in a matter where children are
involved, please attach the welfare report.
D. Specific Guidelines on Making Claims for Appeal Matters
Please ensure that the court order on the outcome of the matter is attached with the claim
form.
E. Specific Guidelines on Making Claims for Prison Visits
Please ensure that the Malaysian Prison Department (usually Bahagian Rekod) stamps your
letter with its rubber stamp on the day of your prison visit, as proof of your visit.
Please take note that these guidelines are effective from 1 Dec 2016 (Thursday). Any claims
submitted after 1 Dec 2016 that are not in compliance with these guidelines will be rejected
by the State LACs.
If you have any questions or require any clarification in respect of this circular, kindly contact
the Bar Council YBGK Secretariat by telephone at 03-2072 2050 (Sumitra Veeriah), or by
email at sumitra@kllac.com. Alternatively, you may also contact your State LAC.
Thank you.
Ravi Nekoo
Chairperson

Circular No 001 2017 LW

Transféré par

Informations du document

Description originale:

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Circular No 001 2017 LW

Transféré par

Droits d'auteur :

Formats disponibles

Circular No 001/2017/LW

Dated 19 Apr 2017

YAYASAN BANTUAN GUAMAN KEBANGSAAN

Date: ………………………………. Time of Arrest: ………………..

PART C: DETAILS OF ARREST:

Investigation done by the police

PART E. FACTS OF CASE & ADVICE GIVEN

YAYASAN BANTUAN GUAMAN KEBANGSAAN

Sex: M / F Age: .................... Special Circumstances (if any):

DETAILS OF ARREST & OFFENCE:

OTHER OFFENCE DRUG ABUSE/CONSUMPTION

Court No: Magistrate:

1st Surety 2nd Surety

Bail application details/comments:

Bail Amount Granted: RM

Conditions of Bail : ……………………………………………………………………………...

YAYASAN BANTUAN GUAMAN KEBANGSAAN

Court No: Magistrate:

6) Date of Arrest : ………………………………………………………………………

7) Remand : YES/NO Remanded Since: …………………

8) Charge : Section (s) :

3) Role of Accused : ……………………………………………………

4) Did Accused gain from crime : ……………………………………………………

5) Influence of external circumstance : ……………………………………………………

6) Victimless crime : ……………………………………………………

7) Special Circumstances : ……………………………………………………

8) Medical Condition : ……………………………………………………

YAYASAN BANTUAN GUAMAN

10) Marital Status : Single / Married / Divorce

11) No of children : ………………… Age: …………………

12) Sole Breadwinner : Yes/No

13) Family Background/ Circumstance : ……………………………………………………

14) Any previous conviction : Yes / No

If yes please state the previous convictions below:

Sentence passed by Court:

If custodial sentenced: Yes/No

Personal Details of Lawyers

Date From To Type of Work Distance Rate Amount

Date From To Type of Work Mode of Transport Amount

B. Grand Total of Travel Claims: C. Miscellaneous Claims

I hereby declare that all particulars stated herein are true.

Details of Lawyer Stamped By

A) PARTICULARS OF LEGAL CLAIMS

I hereby declare that all particulars stated herein are true.

A. Particulars of Legal Claim

Name of OKT: Name of OKT:

I hereby declare that all particulars stated herein are true:

Name Bank Name

Address Email Address

Client’s Name Court

C. If client changes plea and Pleads Guilty

Date of Change of Plea/Reasons Mitigating Factors Sentence

YAYASAN BANTUAN GUAMAN KEBANGSAAN

I hereby declare that all particulars stated herein are true

Details of Lawyer Stamped by:

Client’s Name Court

C) Particulars of Legal Claims for Criminal Files

Details of Lawyer Stamped by:

To Yayasan Bantuan Guaman Kebangsaan (“YBGK”) lawyers

(a) Arrest Interview Sheet — A1 (a) and A1 (b);

Date: ………………………………. Time of Arrest: ………………..

PART C: DETAILS OF ARREST:

Investigation done by the police