Nova Scotia Legal Aid Online Application Form

Financial Information

Do you give permission for Nova Scotia Legal Aid to contact your case worker? *

Yes

No

Employer or Name of Person who can verify your financial information:

Phone Number:

Are you CURRENTLY in jail? *

Yes

No

Do you have children that you support financially or are under the age of 19? Please note: Leaving this information out WILL result in the delay of your application processing. *

Yes

No

Number of Children (click the up or down arrow to change the number):

Child 1 (if you don't fill this in your application will be delayed as we will have to contact you again)

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 2

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 3

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 4

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 5

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 6

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 7

Name

Date of Birth:

Who does the child live with?

City/Town name:

Child 8

Name

Date of Birth:

Who does the child live with?

City/Town name:

Nova Scotia Legal Aid handles a variety of different legal matters for Nova Scotians. What type of legal matter do you have? Family:

separation, divorce, custody, access, child support, alimony. Child Protection (CFSA/MMFS):

Matters where the other party is Child Protective Services or Mi'Kmaw Family and Children Services. Criminal:

Criminal charges have been laid against you or will be laid, includes traffic offences. Social Justice:

EI, CPP, Income Assistance, disability, residential tenancies. Involuntary Psychiatric Treatment Act:

If you are being held in a hospital involuntarily under the IPTA. Other:

NSLA may assist with other matters, as per our website.

FAMILY LAW

Are you or your children experiencing family violence, abuse or intimidation involving the other party in this matter? *

Yes

No

Why do you need help? *

Please indicate briefly why you need help. Do not go into great detail - you have only 180 characters (2 lines)

Name of Opposing Party: *

All family matters have at least two sides. Who is the opposing party in your matter? If you have a date of birth for them this would also be helpful.

CHILD PROTECTIVE SERVICES (CFSA/MMFS)

Why do you need help? *

Please indicate briefly why you need help. Do not go into great detail - you have only 180 characters (2 lines)

Name of Opposing Party: *

Please enter the name of the opposing party:

Name of Social Worker:

If you have the name of the social worker involved in the case, please provide it:

Do you have a yellow card?

A yellow card is a card given to you by social services. If you were given one in relation to this matter please select yes.

Yes

No

Criminal Law:

Is your criminal charge subject to the Youth Criminal Justice Act? *

Were you under the age of 18 years of age on the date(s) when the police think you committed an offence?

Yes

No

Charges: *

What have YOU been charged with or do you anticipate being charged with? Do not fill in someone else's charges here (for example, if your estranged spouse is being charged with domestic violence).

Name of Opposing Party: *

Who is the complainant(s) in your case, or the alleged victim(s)? If you have a date of birth for them this would also be helpful.

Social Justice Law:

Select the type of Social Justice Matter you have: *

Canada Pension Disability (CPP)

Employment Insurance (EI, CERB)

Income Assistance (IA)

Residential Tenancies and other Landlord/Tenant matters

Will

Power of Attorney

Other Social Justice matter

Name of Opposing Party: *

All social justice matters have at least two sides. Who is the opposing party in your matter? If you have a date of birth for them this would also be helpful.

*

Please briefly describe the matter you need help with. Please note that Nova Scotia Legal Aid does not provide services in all matters. Please see our website for full details on what type of matters we provide services for. What we do - What Legal Services Provided

Other Matters:

Other Matters: *

Please briefly describe the matter you need help with. Please note that Nova Scotia Legal Aid does not provide services in all matters. Please see our website for full details on what type of matters we provide services for. What we do - What Legal Services Provided

IPTA:

Reason for review *

IPTA (being held in hospital)

CTO (Community Treatment Order)

Treating Hospital/Facility: *

Unit Name:

Unit Phone Number:

Name of Person filling out application:

Phone Number:

Other Information:

Please provide any additional information that you think may be helpful. Please be brief as you are limited to roughly two lines of information.

Court Information

Do you have to attend court for your matter?

Yes

No

What city/town is the court in?

If your court appearance will be by phone or video do not use your home address as the court location in this section. PLEASE USE THE LOCATION OF THE COURT YOU ARE CALLING IN TO.

Next Court Date

Time

Their names and phone numbers:

Have you received Nova Scotia Legal Aid before? *

Please note: This does not include Dalhousie Legal Aid or any out of province Legal Aid.

Yes (I had the same name I do now)

Yes (I had a different name at the time)

No

If you had a different name the last time you had Legal Aid, what was it?

Has your family or financial situation changed?

If your family or financial situation hasn't changed since the last time you had legal aid please note this - this may help to speed up your application process.

Yes

No

What Nova Scotia Legal Aid office did you receive help from?

Note: If you had a certificate lawyer, you would have seen or been referred by one of the offices below first.

When did you receive help? (Month and year is adequate).

I would like a copy of my application sent to me: *

Yes

No

To what email address?

Declaration and Contact Authorization

READ DECLARATION AND AUTHORIZATION CAREFULLY:

By typing your name below and pressing submit:

- The applicant declares that information provided is true and complete.
- The applicant will provide additional information as required.
- The applicant consents to have information investigated for verification.
- The applicant must notify Nova Scotia Legal Aid of any changes in financial circumstances or living arrangements - failure to comply may result in termination of services.
- The applicant authorizes Nova Scotia Legal Aid to represent and act for Applicant in the matter mentioned or any related matter and further authorizes Nova Scotia Legal Aid to take any necessary action or obtain required assistance.

Signature *

Today's Date *

Form Submission

Please ensure you have completed the form to the best of your ability. Missing information may result in your application's processing being delayed if we have to seek further information from you.

NOVA SCOTIA LEGAL AID

ONLINE APPLICATION FORM