Domestic violence application (s.12 PWDV Act)

A woman's application to the Magistrate for protection, residence and support.

Make it free in Dastavo

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How the paper begins

With Dastavo's sample details; the people and places are fictional. The words in blue are the ones you fill in.

IN THE COURT OF Judicial Magistrate First Class, Amarnagar

Neha Verma wife of Shri Anil Verma, aged about 28 years, resident of House No. 204, Sector 9, Shantipur, District Shantipur, Haryana
…Aggrieved person

Versus

Anil Verma son of Shri Ramesh Verma, aged about 31 years, resident of House No. 204, Sector 9, Shantipur, District Shantipur, Haryana
…Respondent

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

Respectfully Showeth:

1.That the applicant is the wife of respondent No. 1, and his mother Kamla Devi are his relatives who lived with them. The applicant and the respondents lived together in the shared household at House No. 204, Sector 9, Shantipur, and are in a domestic relationship.

2.That the respondents have subjected the applicant to domestic violence, including:

(a)on 20-05-2024 respondent No. 1 slapped and pushed her over a demand for ₹2,00,000

(b)on 01-06-2024 she was turned out of the house with her daughter

3.That the applicant requests that the Protection Officer be directed to prepare a domestic incident report.

4.That the applicant is in fear for her safety and needs the protection of this Court.

The rest of the paper is in Dastavo.

What to bring

Papers to bring

Where to go

Filed through an advocate, the Protection Officer or a service provider before the Judicial Magistrate of the area where you live (even temporarily), where the respondent lives, or where the violence happened; the first hearing is ordinarily fixed within three days.

Fee

Little or no court fee is usually charged; ask the court office. The Protection Officer helps free of cost, and free legal aid is available through the District Legal Services Authority.

Good to know

Papers and fees can change. Check with the office before you go. Guidance only, not yet reviewed by a lawyer.

Stamp paper

Court fee and welfare stamps, where needed, are affixed as the court office directs.