(FJSS) Pro Bono Clearinghouse - Application Form [Version 2]

Family Justice Support Scheme

Pro Bono Legal Clearinghouse

The Pro Bono Legal Clearinghouse grants legal aid to eligible foreign spouses with Singaporean children who require assistance in family law matters.
INSTRUCTIONS

Please proceed with this application form only if you:

1. are a foreigner;

2. are/were married to a Singaporean;

3. have a Singaporean child / Singaporean children.

If you are:

1. a Singaporean / Singapore PR, please approach the Legal Aid Bureau instead.

2. a foreigner but are not married to a Singaporean and/or do not have a Singaporean child / Singaporean children, please apply for legal assistance at our Community Legal Clinic (20-min legal advice session) or Ad Hoc Pro Bono Scheme (legal representation) instead.

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Please note that this application form will require the submission of copies of the following documents:

1. Identification document - e.g. passport, identity card, Dependant's Pass, Work Pass, Long Term Visit Pass etc.

2. Marriage certificate

3. Child's birth certificate

4. Court / other legal documents (if any) - e.g. court orders, court applications, letters/documents from spouse's lawyer etc.

5. Supporting documents for your case (if any) - e.g. photographs, medical report, police report, evidence of maintenance etc.

6. Income document for the last 12 months - e.g. payslips, Income Tax Assessment/IR8A form etc.

7. Bank documents - updated personal and/or joint account bank books or statements, Fixed Deposit receipts and/or any other bank-related information

8. Documents showing the annual value of your place of residence, if you own or co-own the property

If you have these documents ready, this application form should take about 20-30 minutes to complete.
COLLECTION, USE AND DISCLOSURE OF PERSONAL DATA

Your personal data is collected for any or all of the following purposes:

(a) performing obligations in the course of or in connection with our provision of services in the form of legal advice and/or legal representation as requested by you;

(b) verifying your identity;

(c) responding to, handling, and processing queries, requests, applications, complaints, and feedback from you;

(d) managing your relationship with us;

(e) processing payment or credit transactions;

(f) complying with any applicable laws, regulations, codes of practice, guidelines, or rules, or to assist in law enforcement and investigations conducted by any governmental and/or regulatory authority;

(g) any other purposes for which you have provided the information;

(h) transmitting to any unaffiliated third parties including our third party service providers and agents, and relevant governmental and/or regulatory authorities, whether in Singapore or abroad, for the aforementioned purposes; and

(i) any other incidental business purposes related to or in connection with the above.

We may disclose your personal data

(a) where such disclosure is required for performing obligations in the course of or in connection with our provision of legal services in the form of legal advice and/or legal representation as requested by you; or

(b) to third party service providers, agents and other organisations we have engaged to perform any of the functions listed above for us.

The purposes listed in the above clauses may continue to apply even in situations where your relationship with us (for example, pursuant to a contract) has been terminated or altered in any way, for a reasonable period thereafter (including, where applicable, a period to enable us to enforce our rights under any contract with you).
WITHDRAWING CONSENT

The consent that you provide for the collection, use and disclosure of your personal data will remain valid until such time it is being withdrawn by you in writing. You may withdraw consent and request us to stop using and/or disclosing your personal data for any or all of the purposes listed above by submitting your request in writing or via email to our Data Protection Officer at this email address: DPO@probono.sg.

Upon receipt of your written request to withdraw your consent, we may require reasonable time (depending on the complexity of the request and its impact on our relationship with you) for your request to be processed and for us to notify you of the consequences of us acceding to the same, including any legal consequences which may affect your rights and liabilities to us. In general, we shall seek to process your request within ten (10) business days of receiving it.

Whilst we respect your decision to withdraw your consent, please note that depending on the nature and scope of your request, we may not be in a position to continue providing legal services in the form of legal advice and/or legal representation to you and we shall, in such circumstances, notify you before completing the processing of your request. Should you decide to cancel your withdrawal of consent, please inform us in writing via DPO@probono.sg. Please note that withdrawing consent does not affect our right to continue to collect, use and disclose personal data where such collection, use and disclose without consent is permitted or required under applicable laws.
Consent to the above PDPC policy*

In providing my personal data here, I agree that Pro Bono SG may collect, use and disclose my personal data in accordance with the purposes as stated above.

LEGAL ADVICE / REPRESENTATION
Have you sought legal advice on this matter before?*

YesNo
Details of prior legal advice*
e.g. Attended legal clinic at State Courts on [date]
Are you currently represented by a lawyer?*

YesNo
Name of lawyer*
Do you intend to discharge your lawyer?*

YesNo
If you are already legally represented, why are you applying for assistance under FJSS?*
Have you ever been represented by a lawyer?*

YesNo
Name of previous lawyer*
Why are you no longer represented by the lawyer?*

MEANS TEST

Part 2: Property
Do you own or co-own your place of residence (in Singapore or overseas)?*

YesNo
Is your place of residence your matrimonial home?*

YesNo
Annual value of place of residence (S$)*
Annual value is the estimated gross annual rent of the property if it were to be rented out - e.g. rental of $500 per month x 12 = $6,000
Name(s) of other owner(s) of place of residence*
Enter 'NA' if you are the sole owner.
Please upload document(s) showing the annual value of your place of residence.*

Browse Files
E.g. any property notices or letters in your IRAS MyTax Portal, document showing rental value. Cancelof
Do you own any other property (in Singapore or overseas)?*

YesNo
Address and value of other property*

MEANS TEST

Part 3: Savings and investment
Do you have a bank account (in Singapore or overseas)?*

YesNo
Total amount in bank account(s) (as of date of application) (S$)*
Please upload your bank document(s).*

Browse Files
E.g. updated personal and/or joint account bank books or statements, Fixed Deposit receipts and/or any other bank-related information Cancelof
Amount of cash savings (as of date of application) (S$)*
Do you have any shares and/or investment(s) (in Singapore or overseas)?*

YesNo
Please provide amount and details of shares / investment(s).*
Please upload documents related to shares / investment(s) (if any).

Browse Files

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MEANS TEST

Part 4: Spouse's particulars
Is your spouse working?*

YesNo
Spouse's job title*
Spouse's monthly salary*
Type 'unknown' if you do not know.
Are you staying with your in-laws?*

YesNo

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Part 5:
Note: If it is subsequently discovered that the nett value of matrimonial assets liable for division exceeds S$550,000, you will no longer qualify for pro bono legal assistance. If you have been assigned a lawyer, the assigned lawyer can quote fees for the subsequent stages. If you do not agree with the assigned lawyer's fees, the assigned lawyer is free to discharge and/or you may choose to engage your own lawyer.
*

I understand and agree with the above. I would like to proceed with my application.

HOUSEHOLD EXPENSES AND CHILDREN
Details of how each spouse has contributed to the household expenses*
E.g. Applicant has paid school fees for all 3 children at a total of $100.00; Husband gives $300.00 for groceries and living eexpenses per month
Number of Children*
Is your child / Are your children from this current marriage with the spouse listed above?*

YesNo
Name and Age of Child / Children*
Please indicate each child's age clearly (e.g. Sarah Tan, 7 years old; Brandon Tan, 10 years old)
Current Address of Child / Children*
Please provide the address of each child clearly if living separately (e.g. Sarah Tan - Blk 123 Apple Road; Brandon Tan - Shelter (with applicant))
Please upload the birth certificate(s) of your child / children.*

Browse Files

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Areas of Assistance
1. Please ensure that you select and mention all areas of assistance required, e.g. divorce, protection orders, maintenance, children-related issues.

2. If you bring up an issue after a lawyer has been assigned, such matters will be assessed on a case-by-case basis.

3. Please note that if there are multiple issues involved (e.g. PPO, divorce, maintenance, custody), and/or if any additional matter arises after the assignment of a lawyer:

(a) There may be more than 1 lawyer handling your case (e.g. one lawyer handling the divorce, another lawyer handling the PPO application);

(b) There may be a change in lawyer if the existing assigned lawyer is unable to manage; and/or

(c) You may have to manage some applications on your own.
*

I understand and wish to proceed.

MAINTENANCE
Do you require assistance with maintenance?*

YesNo
Who is the maintenance application for?*

SelfChild(ren)Self and Child(ren)
Status of maintenance application*

Not filedPendingConcluded
Please upload any Court document(s).

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Amount of monthly maintenance applied / to apply for self*
Enter '0' if not applying for maintenance for self
Amount of monthly maintenance applied to apply for child / children*
Enter TOTAL amount of maintenance applied for all children; enter '0' if not applying for maintenance for children
Breakdown of monthly maintenance for children
Please state how much maintenance you wish to apply / have applied for each child (E.g. Sarah Tan - $400; Brandon Tan - $200). Enter 'NA' if not applying for maintenance for children.
Please upload any supporting document(s).

Browse Files
E.g. record of expenses, receipts, invoices etc. Cancelof
Any other comments

Division of Matrimonial Assets
Do you require assistance with division of matrimonial assets?*

YesNo
Please list out assets owned jointly or shared by both parties.*
e.g. matrimonial home, joint bank account etc. Enter 'NA' if none.
Please list out assets owned solely by you (Applicant).*
e.g. savings, investments, insurance policies, property (Singapore or overseas), company etc.
Please list out assets owned solely by your spouse (to the best of your knowledge).*
e.g. savings, investments, CPF money, insurance policies, property (Singapore or overseas), company etc.

SOCIAL SUPPORT & OTHER INFORMATION
Details of Family/Social support granted to applicant (if any)
Are you receiving help from an embassy?

YesNo
Additional Facts/Background information on applicant (if any)
DETAILS OF CASE WORKER
Referring Organisation
Case worker / Contact person
E-mail
example@example.com
Contact Number

DECLARATION AND CONDITIONS
The information provided by me in this application is true and complete to the best of my knowledge and I have not omitted to declare any material fact.

If it is discovered that I had knowingly made a false statement or representation in my application, I will face one/all of the following consequences:

1. I will be prohibited from receiving assistance from FJSS.

2. A police report may be made.
*

I understand and agree with the above.
Signature

Clear
Should be Empty:

	Name of Employer	Job Title	Monthly Salary (S$)
Month 1
Month 2
Month 3
Month 4
Month 5
Month 6
Month 7
Month 8
Month 9
Month 10
Month 11
Month 12

	Relationship to Applicant (e.g. mother, father, brother etc.)	Total amount provided in the last 12 months (S$)	Dependent's job (if any)	Dependent's total income in the last 12 months (if any)
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Dependent 6

Family Justice Support Scheme

APPLICANT'S PERSONAL DETAILS

LEGAL ADVICE / REPRESENTATION

DETAILS OF SPOUSE/OPPOSING PARTY

MEANS TEST

MEANS TEST

MEANS TEST

MEANS TEST

Heading

GENERAL MARRIAGE DETAILS

LIVING ARRANGEMENTS

HOUSEHOLD EXPENSES AND CHILDREN

Areas of Assistance

DIVORCE

PROTECTION ORDERS

MAINTENANCE

Division of Matrimonial Assets

CHILDREN ISSUES

SOCIAL SUPPORT & OTHER INFORMATION

DETAILS OF CASE WORKER

OTHER DETAILS

DECLARATION AND CONDITIONS