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Personal Details: (Optional) Date: 23/03/14

Name: Mr. Govinda Toshniwal
Tel Number: 9964121746 Email:

Please assist us to evaluate the scope of our services.

1. Have you ever felt need of a legal personnel/lawyer available to you? No
2. Are you aware of your legal rights in all fields of law? No (Not in all
fields, but well versed in the fields which I currently work in.)
3. Are you aware of legal obligations in all fields of law? No (as stated
in point 2.)
4. Do you feel that legal knowledge in relevant field would assist you in your daily
professional and personal activities? Yes
5. Do you feel that someone should assist you in getting basic functional knowledge
whenever required? Yes (depends
on the kind of work I am into.)

6. If Yes, then what type assistance would be appropriate:
formal session of less than 2 hours Yes
visit to office whenever required No
one to one telephone conversation Yes
booklet pamphlets Yes (whenever required)
any other
7. Which safety needs you give more priority: Highest Priority 1 Lowest priority 5
Physical safety 4
Health safety 3
Social safety 5
Community safety 5
8. When are you most exposed to risks? Day/ Night (None)
9. Whether your professional or personal activities lead you to go out of your residence in
night? Yes

10. Do you feel that someone should accompany you in case of some untoward incident,
especially in night? No (Depends)

11. Do you feel that someone should be available to assist you within reasonable time
frame in case you need assistance? Yes (Depends, If the matter requires someones
12. What type of emamong people is very much required..ergency one can think of, where
legal knowledge and legal assistance shall be of much value :
12.1 Road accident Yes
12.2 Vehicle breakdown No
12.3 Theft/robbery Yes
12.4 Minor or major alterations or scuffle with service provider Yes
12.5 Fire No
12.6 Threatening or abusive behavior Yes/No (Yes if
threating & NO If absive, Depends on the scenario)
12.7 Unknown person knocking house in day/night No
12.8 Victim of some crime Yes
12.9 Sudden notice/call from police Yes
12.10 Nuisance in neighborhood Yes
12.11 Stalking Yes
12.12 Harassment/ exploitation at work place/outside Yes
12.13 Inappropriate behavior at work place Yes
12.14 Abuse of authority by public servant/govt employee Yes
12.15 Non delivery of service protected under Consumer Laws Yes
12.16 Non delivery of service by the government offices Yes
12.17 Insurance/liability interpretation Yes
12.18 Non registration of complaint by Police Yes
12.19 Whether should I re-verify contract/agreement Yes
12.20 What are the Court procedures Yes
12.21 Notice/ Summon/ Warrant from Court or Police Yes
12.22 Legal Notice from lawyer Yes
12.23 People look like law enforcing agency, have approached Yes