Family and matrimonial

Application under section 12 of the Protection of Women from Domestic Violence Act, 2005 with affidavit and lists

0 of 125 blanks filled

IN THE COURT OF THE CHIEF METROPOLITAN MAGISTRATE, GHAZIABAD, UTTAR PRADESH

COMPLAINT NO. Complaint number/Complaint year

IN RE: -

Complainant's nameComplainant

Versus

Respondents' namesRespondents

INDEX

S.No.ParticularsPage No.Court Fee (Rs. Court fee amount (₹))
1Memo of Parties
2Application under section 12 of the Protection of Women from Domestic Violence Act, 2005, along with the affidavit of the complainant
3List of Witnesses
4List of Documents
5Vakalatnama
Date:Complainant/Aggrieved Person
Place:Through Counsel
Counsel's law firm name & AssociatesOffice No. X, Law firm office number and building, Law firm address line, Mob.: Law firm mobile number

IN THE COURT OF THE CHIEF METROPOLITAN MAGISTRATE, GHAZIABAD, UTTAR PRADESH

COMPLAINT NO. Complaint number/Complaint year

IN RE: -

Complainant's nameComplainant

Versus

Respondents' namesRespondents

MEMO OF PARTIES

Complainant's name, W/o Complainant's father's/husband's name, R/o Complainant's residential addressComplainant

VERSUS

1. Respondent no.1's name, W/o Respondent no.1's father's/wife's name, R/o Respondent no.1's residential addressRespondent No. 1
2. Respondent no.2's name, W/o Respondent no.2's father's/wife's name, R/o Respondent no.2's residential addressRespondent No. 2
3. Respondent no.3's name, W/o Respondent no.3's father's/husband's name, R/o Respondent no.3's residential address, Also at: R/o Respondent no.3's alternate addressRespondent No. 3
Date:Complainant/Aggrieved Person
Place:Through Counsel

IN THE COURT OF THE CHIEF METROPOLITAN MAGISTRATE, GHAZIABAD, UTTAR PRADESH

COMPLAINT NO. Complaint number/Complaint year

IN RE: -

Complainant's nameComplainant

Versus

Respondents' namesRespondents

APPLICATION TO THE MAGISTRATE UNDER SECTION 12 OF THE PROTECTION OF WOMEN FROM DOMESTIC VIOLENCE ACT, 2005

MOST RESPECTFULLY SHOWETH: -

1.That the marriage between the Complainant and Respondent No. 1 was solemnised on Xth Month of marriage, Year of marriage, in accordance with Hindu rites and customs at Marriage venue city, Marriage venue detail.
2.That Respondent No. 1 is the husband, Respondent No. 2 is the father-in-law, and Respondent No. 3 is the mother-in-law of the Complainant.
3.That the parents/guardians of the Complainant spent approximately more than Rs. Amount spent on marriage (₹, in lacs) lacs on the marriage, which was celebrated with pomp and show. On the occasion of the marriage, substantial cash, gifts, clothing, and gold ornaments were given by the parents of the Complainant. The dowry articles and Istridhan, including the jewellery of the Complainant, remain in the custody of the mother-in-law of the Complainant.
4.That after the solemnisation of the marriage, the above-named in-laws commenced harassing and taunting the Complainant on the ground that her parents had not given sufficient dowry in accordance with their expectations and their standard and status, notwithstanding that the parents of the Complainant had spent a substantial amount on the marriage. This conduct and behaviour of Respondents Nos. 1 to 3 caused grave mental tension and physical trauma to the Complainant.
5.That in connection with the marriage of the Complainant, her parents spent beyond their capacity and presented all the dowry items, including jewellery, furniture, electrical appliances, utensils, clothes, etc., at the time of the marriage, expending approximately more than Rs. Amount spent on marriage (₹, in lacs) (lacs) thereon. After the marriage, the Complainant was subjected to torture for not bringing dowry items as demanded by the respondents.
6.That after the solemnisation of the marriage, the Complainant and Respondent No. 1 came to [STATE NAME] at First matrimonial home address, and Respondents Nos. 2 and 3 also visited from time to time along with Respondent No. 1 at Address where respondents 2 and 3 stayed.
7.That on Date of shifting residence.0X.Year of shifting residence, the Complainant and Respondent No. 1 shifted to Name of city/area shifted to. That on the intervening night of Date of Valentine's Day incident.0X.Year of Valentine's Day incident, while celebrating Valentine's Day with the Complainant, Respondent No. 1 offered her a drink (wine), which the Complainant declined, whereupon Respondent No. 1 showed her a video of his ex-girlfriend from the period when he was working at Name of former employer. After Valentine's Day, the Complainant came to learn that Respondent No. 1 was a habitual drinker (wine and whisky) and began forcing the Complainant to drink, telling her that since the wife of his friend consumed alcohol, she too should consume wine and whisky.
8.That for some days the Complainant was unable to have physical relations with Respondent No. 1, as he would become so intoxicated that he physically tortured her, behaved like an animal, committed unnatural sex, and repeatedly demanded oral sex from the Complainant, on account of which she did not have relations with him as husband and wife. Respondent No. 1 conveyed this to Respondents Nos. 2 and 3 in the words "woh mere saath relationship nahi bana rahi hai", conduct which was wholly unexpected of Respondent No. 1 by the Complainant.
9.That on Date of leg fracture incident.Year of leg fracture incident, the Complainant's leg was fractured because Respondent No. 1 beat her badly and pushed her so hard against a wall that one of her legs was fractured. The doctor advised complete bed rest, and even during that period of bed rest, Respondent No. 1 forcibly had unnatural relations (guda maidun) with her and compelled her to perform oral sex. Thereafter, being unable to tolerate Respondent No. 1 any longer, the Complainant went to her parents' house. Respondent No. 1 then telephoned the Complainant's father and said, "Apki beti mere saath sex nahi kar rahi hain". The Complainant's father remained silent for some time, having never expected such words from his son-in-law in front of the entire family. Respondent No. 1 further said, "Mujhe car lena hain toh car book karne ke liye aur paise do". Upon hearing of this incident, the Complainant's father suffered a minor heart attack and was hospitalised. Respondent No. 1 neither wished to see the Complainant's father nor enquired about his health over telephone calls to the Complainant. When the Complainant's father was discharged from hospital and returned home, Respondent No. 1 called him and said, "Quote - month of cousin's wedding me iske cousin brother ki shadi hain Ranchi me, toh isko direct wahin bheje, Quote - word in husband's threat nahi bheje".
10.That Respondent No. 1 habitually threatened the Complainant in the words, "Abhi aisa kar liya hai, aage aisa hua to tumhare saath kitna bura hoga, tumko bhi koi andaza nahi hain is baat ka". On one occasion, when the Complainant had gone to Delhi for a job interview and, being in the midst of the interview, did not answer his call, Respondent No. 1 said, "Phone uthalo, varna aaj jo haal hoga tumhara tumhe idea nahi hain".
11.That Respondent No. 1 consumed whisky in an intoxicated state every day and had unnatural physical relations, including oral sex, with the Complainant, placing his male organ in her mouth, and did so even during her menstruation, which constitutes inhuman behaviour on the part of Respondent No. 1. Whenever the Complainant declined physical relations at night, Respondent No. 1 would cancel all plans for the following day, such as watching a film, shopping, and going out for dinner, saying, "Agar relation banane me pati ko khush nahi kar sakti ho, ghar pe baitho". Respondent No. 1 was so shameless that on occasion he even telephoned the Complainant's parents and said, "Quote - complainant's name used by husband ko bol dijiye, mere saath relation banana hai to jaisa me kehta hun, pati patni ka rishta waisa hi hoga; wo bahut jyada thandi hai aur sex me bilkul support nahi karti hai".
12.That after the marriage, on the occasion of the first Holi festival, the parents of Respondent No. 1, namely Respondents Nos. 2 and 3, came to Place where in-laws stayed on first Holi and stayed for a few days, and thereafter proceeded to Dehradun, Uttarakhand. Some time after that trip, while sweeping the room, the Complainant found a lady's sandal, which she showed to Respondents Nos. 2 and 3, whereupon the father-in-law of the Complainant said, "Teri saas tere liye hi layee hai, abhi bazaar se", whereas in fact the mother-in-law never went to the market alone for shopping. After this incident, the Complainant came to learn that Respondent No. 1 was having an illicit relationship. When the Complainant saw the mobile phone of Respondent No. 1, she found numerous messages and calls from Girlfriend's phone number. The Complainant called Girlfriend's phone number and enquired about the relationship with Respondent No. 1, and the lady stated that she was the girlfriend of Respondent No. 1 and that the two were soon to be married. The girlfriend, Girlfriend's name, was unaware that Respondent No. 1 was married to the Complainant. This incident made the life of the Complainant hell, and she was badly beaten by Respondent No. 1.
13.That on Date in-laws visited Year in-laws visited, respondent nos. 2 and 3 came to respondent no. 1's house at Husband's house address, and thereafter they both proceeded to Dehradun, Uttarakhand, where respondent nos. 2 and 3 tortured the complainant by saying, "ki tere parents pital ka jewellery de diye hain or Name used in taunt about light chain ko itna halka chain diye hain ki kahin humara beta pehen ke bhi nahi ja sakta hain who, bekar ka bete ki shadi kar di, 2 saal baad bete ki shadi karte hum bahu ke naam par bas surat mila hain gunn ke naam par kuch nahin hain is ladki me".
14.That on Date of Bokaro Diwali visit Year of Bokaro Diwali visit, during Diwali, the complainant and respondent no. 1 went to Bokaro on account of the funeral ceremony of respondent no. 1's nani. That respondent no. 1 booked the train tickets through "Train name". That during the festive season, the train was fully crowded, and the complainant told respondent no. 1 that she did not feel safe in the train, but respondent no. 1 paid no attention, whereupon the complainant alighted from the train. That respondent no. 1 became angry and beat the complainant in front of all the passengers on the platform, and from Station where beating occurred to Bokaro she was tortured by respondent no. 1. That when the funeral ceremony concluded, the complainant was forced to go to her parents' house; the complainant went to her parents' house, attended Chhath Puja, and returned to Address complainant returned to.
15.That on Date of false allegations.Month/year of false allegations, respondent no. 1 made false allegations against the complainant, in front of all the neighbours, that she was having an affair with her brother-in-law. That after this incident, the complainant stopped talking to her brother-in-law, as respondent no. 1's family did not approve of such contact. That respondent no. 3, the mother-in-law, told the complainant, "teri shadi ho gayi hai aur tum apne parents se bhi baat nahin karna zyada or na ki kisi friends se aur jija se to bilul nahi".
16.That the complainant did everything as directed by respondent nos. 1, 2 and 3, and yet, whenever the complainant visited the respondents' relatives' houses and spoke to them with a smile, the respondents felt displeased, and upon returning home the respondents' family demanded of her, "tumhare waah pe kis-kis se kya baat huyi, tumne wah pe aisa kyun bola".
17.That in the year Year complainant became certain, when the complainant became certain that respondent no. 1 was having an affair with Name of husband's girlfriend, she warned respondent no. 1 to end the relationship, failing which their own relationship could not continue. That thereupon respondent no. 1 beat the complainant mercilessly throughout the night at home, at Location of beating, Address detail of beating location. That having been grievously injured by the said beatings, the complainant telephoned her parents and resolved not to tolerate such behaviour of respondent no. 1 any longer, and the complainant went to her parents' house.
18.That in Month husband visited parents' house Year husband visited parents' house, respondent no. 1 came to the complainant's parents' house and promised her that he would not continue his relationship with Name of girlfriend any further, and respondent no. 1 also deleted Girlfriend's name's contact number from his phone. That thereafter, in the month of Month complainant returned, the complainant came to City complainant moved to with respondent no. 1, and at that time the complainant and respondent no. 1 shifted to their new house at New house address detail.
19.That for a few days matters remained normal, but thereafter respondent no. 1 compelled the complainant to take up a job and said, "kuch bhi ho ghar se bahar niklo aur kamakar lao". That when the complainant was unable to secure employment, respondent no. 1 harassed her mentally and beat her physically every day on the sole ground that she was not working, and further said, "tujhse se to Word in husband's taunt about job good hai tera patta saaf hone wala hai". That the complainant then realised that respondent no. 1 was still in touch with Name of girlfriend and that the relationship was continuing, and on that day the complainant gave up all hope from respondent no. 1.
20.That after the above incident, respondent no. 1 levelled an allegation of theft against the complainant, in respect of household articles and money, and respondent no. 1 telephoned all the family members of the complainant in this regard.
21.That despite all these incidents, the complainant did not abandon hope of a happy life and of all good things in the future; however, respondent no. 1 did not desist from beating her, and this continued for months and years at Place of continued harassment. That sometimes the complainant's family members intervened, but respondent no. 1 was so obstinate that he never heeded anyone, and he continued to commit unnatural sex and oral sex upon the complainant. That respondent no. 1 habitually showed blue (sex) films to the complainant and asked her to do the same as depicted in such films, and whenever she refused, the complainant was beaten by respondent no. 1 at Place of beating, Address detail of beating place.
22.That on Date of sister's marriage incident 0X, Year of sister's marriage incident, on the occasion of the marriage of respondent no. 1's sister, the complainant called a parlour attendant for make-up, whereupon respondent no. 1 and his family began taunting the complainant, saying, "ki kyun bulaya tumne parlour wali ko ready hone ke liye" and further saying, "paisa kya tera baap aakar dega". That respondent nos. 2 and 3, being exceedingly greedy, demanded Rs. Amount demanded from complainant (₹, in lakhs) lakhs from the complainant and said, "apne ghar phone karke magaa, Word in in-laws' quote ne bahut kah liya ab hum kah rahe hain", and also told the complainant, "tum Name used in in-laws' instruction ko baatein mat btaya karo apne ghar main". That when the complainant refused to telephone her parents, respondent nos. 2 and 3 quarrelled with her and beat her with an iron rod. That when the complainant conveyed this to her parents, they gave Rs. Amount given to respondents (₹, in lakhs) lakhs to respondent nos. 2 and 3 and expressed their inability to give more. That when respondent no. 2 learnt that the complainant's parents were unable to give money, he changed his conduct, and one day, when respondent nos. 1 and 3 were not at home, he imposed himself upon the complainant and attempted to have intercourse with her, besides committing several other acts on that day, whereby the complainant lost all faith in him as a father figure. That the complainant conveyed the said incident to her parents, and her parents asked her not to lodge any police complaint and informed her that they were coming to Place where parents came. That the complainant narrated the entire ordeal to her parents in the presence of respondent no. 1, but respondent no. 1 refused to believe her and told her parents that the complainant was a characterless lady who could level allegations against anyone, whereupon the complainant's parents left Place parents left with complainant along with the complainant.
23.That in the year Year husband apologized, before Diwali, respondent no. 1 came to the complainant's parental house, apologised for all that had been done, sought forgiveness for his past acts, and offered to give a written apology. That since it was the Diwali festival, the parents, after discussion with the other family members, decided to send the complainant with respondent no. 1. That upon reaching Ghaziabad, the complainant and respondent no. 1 quarrelled, and in the course thereof respondent no. 1 pushed the complainant down the stairs, as a result of which the complainant was badly injured and sustained a fracture. That respondent no. 1 was so mean that he said to her, "tumhare pass mera credit Card hai, tum khud chali jaao Doctor ke pass mere pass time nahi hai tumhe le ke jaane ka".
24.That after Diwali, respondent no. 1 resigned from his job at Name of husband's former employer on Date of resignation, and thereafter joined Name of new employer, from which office he was dismissed within 10 days. That respondent no. 1 remained jobless until February 2018, and respondent no. 1 asked for Rs. Amount asked by husband (₹, in lakhs) lakhs, and the complainant's parents gave Rs. Amount given by parents (₹, in lakhs) lakhs to respondent no. 1.
25.That in February Year husband joined employer, respondent no. 1 joined Name of employer joined in February Employer detail at Employer location, and he also selected Name of new employer selected, while respondent no. 1 wished to join Name of employer husband wanted to join. He gave an excuse in respect of Name of employer husband wanted to join that "meri wife marne marne pe hain usko main vellore le kar jana hain".
26.That in Month of WhatsApp recording Year of WhatsApp recording, the Complainant received a WhatsApp message regarding a telephonic conversation between respondent no. 1 and Name of woman in recording, and the said recording was sent by the husband of Name of woman's husband to several persons. Upon receipt of the said recording, the Complainant learnt that Name of married woman involved is now married and that her husband is greatly distressed as his wife is having an extra-marital relationship with respondent no. 1. The WhatsApp recording stated, "main tum se shadi tab karunga jab tum apne pati ko divorce de dogi". The Complainant also received information that respondent no. 1 had other love affairs with other women, namely Ms. Name of batch mate, who was his batch mate, and Ms. Name of client, who was his client when respondent no. 1 was working at Name of employer where husband worked.
27.That in the month of Month of return from aunt's house Year of return from aunt's house, respondent no. 1 returned from his aunt's house along with the Complainant, and respondent no. 1 attempted to push her out of the car, saying, "sali kutti main tujhe fek dunga car se". When the Complainant narrated this incident to respondent no. 3, her mother-in-law, the latter remarked, "mara to nahi na mere bete ne tumko".
28.That the husband of the Complainant was extremely rude and cruel towards her. He placed a knife against her neck and threatened that if she went to lodge a complaint with the police, she would be killed. As a result, the Complainant sustained several marks of injury on her body. The conduct of respondent no. 1 further worsened when he threw hot oil on the right hand of the Complainant, and he also attacked her and inflicted a knife wound on her left wrist.
29.That one night at about 2:00 a.m., the father-in-law of the Complainant attempted to outrage her modesty. When she raised an alarm and narrated the incident to her husband, the father-in-law, along with the husband, subjected her to a severe beating and threatened her not to disclose the incident to anyone, failing which she would be killed.
30.That respondent no. 1/husband beat her very badly in a bolted room at her home in Location of beating in bolted room. On that day, she made a call to the police, and the police arrived but took no action. After the police left, respondent no. 1 threw her out of the matrimonial house, saying, "police hi tujhe apne paas rakhegi ja jakar police station me hi rah", and did not allow her to enter the home at Address of home complainant not allowed into, saying, "ye makan mere naam aur mere baap ke naam joint ownership me hai aur me tujhe abhi ghar se nikal raha hun, ja apne baap ko bol ki naya makaan lekar de". He expressed his evil intentions and designs to remarry Name of woman husband intended to remarry, and the next day, respondent no. 1 called three persons to show the premises for the purpose of sale, telling the Complainant, "me ye makan bechkar dilli se bahar chala jaunga ja tujhe jo karna hai kar lena". Respondent no. 1 is presently interested in selling the house of the Complainant, where she is residing at present.
31.That the Complainant was shocked by the said conduct of her husband, who, out of lust and greed for extracting more dowry articles, inflicted mental and physical cruelty and torture upon her.
32.That the entire istridhan/dowry articles of the Complainant are in the custody of her husband, who is misappropriating the same and repeatedly threatening the Complainant and her family members.
33.Respondent no. 1 has been openly issuing threats to the Complainant and her family members of elimination from the world. The Complainant reserves her right to lodge a criminal complaint against the respondent and his family members in respect of the same.
34.That the Complainant has been facing hardships in maintaining herself, as she has no source of income and money is required for food, clothing, etc. It is submitted that respondent no. 1 has been living alone at the above-mentioned address since Date respondent living alone at address, and that respondent no. 1 abandoned her and stated that he would soon marry Name of woman husband said he would marry.
35.That all her istridhan articles and belongings are lying with respondent no. 3, who has not returned the same despite repeated requests made by the Complainant.
36.That the Complainant is unable to maintain herself, and respondent no. 1 has wilfully neglected the Complainant and has failed to maintain her.
37.That respondent no. 1 has no other liability except towards the Complainant, as his father is retired from a Government job and is drawing a pension, and his mother is also a Government employee working as a teacher and drawing a good salary. The respondent works as an Export Manager in Name of husband's current employer and draws a salary of more than Rs. Husband's monthly salary (₹)/- per month, and also owns a car and a bike and holds a club membership, enjoying his life lavishly. The Complainant is entitled to claim maintenance of Rs. Monthly maintenance claimed (₹)/- per month from respondent no. 1.
38.That the Complainant has been residing at the above-noted address for many years, and all the incidents, i.e., the beatings, mental cruelty, physical cruelty, dowry demands, etc., occurred at the same premises, which is under the territorial jurisdiction of this Hon'ble Court. Further, the Complainant and respondent no. 1 reside within the territorial limits of P.S. Name of police station, Police station location/city. Hence, this Hon'ble Court has territorial jurisdiction to entertain and try the present petition.
39.That the acts committed by the respondent fall within the definition of domestic violence as enshrined in the Act; hence, this application.

It is, therefore, most respectfully prayed that this Hon'ble Court may take cognizance of the complaint/Domestic Incident Report and pass all or any of the orders deemed necessary in the circumstances of the case:

a)Pass a protection order under section 18 and/or
b)Pass a residence order under section 19 and/or
c)Direct the respondent to pay monetary relief under section 20 and/or
d)Direct the respondent to pay compensation or damages under section 22 and/or
e)Pass such interim orders as the Court may deem just and proper;
f)Pass such other orders as may be deemed fit in the circumstances of the case.

(i) Protection Order under Section 18:

Prohibiting acts of domestic violence by granting an injunction restraining the respondents from repeating any of the acts mentioned in the application.

Directing the respondents to stay away from the Complainant and the parents of the aggrieved person.

(ii) Residence Order under Section 19:

An order restraining the respondent(s) and his agents from disturbing the peaceful possession and residence of the Complainant, along with all her rights as conferred by law, in the shared household at Address of shared household.

That the goods/clothes/articles belonging to the Complainant be kept accessible to her and remain in the shared household only.

(iii) Monetary Relief under Section 20:

Directing respondent no. 1 to pay the following expenses as monetary relief:

Rs. Monthly monetary relief claimed (₹)/- per month for food, clothes and other basic necessities of the Complainant.

(iv) Order under Section 22:

Passing an order under section 22 of the Act providing compensation to the tune of Rs. Compensation amount claimed (₹)/- for the mental and physical injuries, etc., suffered by the aggrieved person, and for the agony suffered, both mental as well as physical, on account of the domestic violence.

PRAYER


It is, therefore, most respectfully prayed that this Hon'ble Court may graciously be pleased to grant the relief(s) claimed herein and pass such order or orders as this Hon'ble Court may deem fit and proper under the facts and circumstances of the case, for protecting the aggrieved person from domestic violence and in the interest of justice.

Applicant/Aggrieved person

Complainant's cityDated

Through

Counsel

VERIFICATION:

Verified at Complainant's city on this Day of verification day of Month of verification, Year of verification that the contents of paragraphs 1 to Last paragraph number verified in the application of the above application are true and correct to the best of my knowledge and belief, and that nothing material has been concealed therefrom.

Applicant/Aggrieved person

IN THE COURT OF CHIEF METROPOLITAN MAGISTRATE, GHAZIABAD, UTTER PRADESH

COMPLAINT NOComplaint number/Complaint year

IN RE: -

Ms. Complainant's nameComplainant

V/s

Mr. Respondent's nameRespondent

AFFIDAVIT UNDER SECTION 23(2) OF THE PROTECTION OF WOMEN FROM DOMESTIC VIOLENCE ACT, 2005

Affidavit

I, Ms. Deponent's name, W/o Mr. Deponent's husband's name, R/o Deponent's residential address, do hereby solemnly affirm and declare on oath as under:

1.That the deponent is the Complainant/Applicant in the accompanying application, which has been filed on her behalf.
2.That, being fully conversant with the facts and circumstances of the case, the deponent is competent to swear this affidavit. The accompanying application has been drafted by the deponent's counsel under her instructions, its contents have been explained to the deponent in vernacular, and the deponent states that the said contents are true and correct.
3.That the Istridhan articles are presently under the care and custody of respondent no. 3.
4.That the details set out in the accompanying application for the grant of reliefs under sections 18, 19, 20 and 23 have been incorporated therein at the instance of the Applicant and on the instructions given by her to counsel.
5.That the contents of the application have been read over and explained to the Applicant in English/Hindi.
6.That the contents of the said application may be read as part and parcel of this affidavit, and are not repeated herein for the sake of brevity.
7.That the Applicant apprehends a repetition of the acts of domestic violence by the Respondents, against which relief is sought in the accompanying application.
8.That the Respondents have threatened the Applicant that she will be eliminated at any point of time.
9.That the reliefs claimed in the accompanying application are urgent, inasmuch as, if the said reliefs are not granted on an ex-parte ad-interim basis, the Applicant would suffer great financial hardship and would be forced to live under the threat of a repetition or escalation of the acts of domestic violence complained of in the accompanying application by the Respondent(s).
10.That the facts stated herein are true and correct to the best of my knowledge and belief, no part of them is false, and nothing material has been concealed therefrom.

Deponent

VERIFICATION:

Verified at New Delhi on this Day of affidavit verification day of Month of affidavit verification, Year of affidavit verification, that the contents of the above affidavit are correct to the best of my knowledge and belief, no part of it is false, and nothing material has been concealed therefrom.

Deponent

IN THE COURT OF CHIEF METROPOLITAN MAGISTRATE, GHAZIABAD, UTTER PRADESH

COMPLAINT NOComplaint number./Complaint year

IN RE: -

Ms. Complainant's nameComplainant

V/s

Mr. Respondent's nameRespondent

LIST OF WITNESSES

1.

2.

3.

4.

DateComplainant/Aggrieved Person
PlaceThrough

Counsel

Counsel's law firm name & Associates

Office no. Law firm office number

Mob-Law firm mobile number

IN THE COURT OF CHIEF METROPOLITAN MAGISTRATE, GHAZIABAD, UTTER PRADESH

COMPLAINT NOComplaint number prefixComplaint number suffix/Complaint year

IN RE: -

Ms. Complainant's nameComplainant

V/s

Mr. Respondent's nameRespondent

LIST OF DOCUMENTS

1.

2.

3.

4.

DateComplainant/Aggrieved Person
Place: Complainant's cityThrough

Counsel

Counsel's law firm name & Associates

Office no. Law firm office number

Mob-Law firm mobile number

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