Certificate of good standing for candidates to the list of counsel

Print Certificate of good standing for candidates to the list of counsel Representative person Position Bar Association / Administrative Authority Name of member / employee Condition of the member / employee Complete address Telephone Registration number Prior conditions, if applicable Fax e-mail address Date of entry / admission / swearing Interruptions, if any in Disciplinary proceedings against member / employee I certify on my honour that the above information is true and correct to the best of my knowledge and belief and that I have verified its contents. Date Signature Seal This Certificate is not valid without the seal. Maanweg 174, 2516 AB The Hague, The Netherlands - Maanweg 174, 2516 AB La Haye, Pays-Bas Telephone - Téléphone +31(0)70 515 85 15 / Facsimile - Télécopie +31(0)70 515 85 55 www.icc-cpi.int