(A sample FIR form is provided below.)
FIRST INFORMATION REPORT
(Under Section 154 Cr.P.C.)
District : Prayagraj P.S. Civil lines Year 2020
FIR No. 0134 Date & Time of FIR : 08/01/2020, 20.51 ‘O’ Clock
| S.No. | Acts | Sections |
| 1 | IPC 1860 | 420 |
3. (a) Occurrence of offence :
1. Day : Night Date From : 01/01/2020
Date To : 08/01/2020
Time Period : Time From : 08:00 ‘O’Clock
Time To : 12:00 ‘O’ Clock
(b) Information received at P.S. :
Date : 08/01/2020 Time : 20:51 ‘o’ Clock
(c) General Diary Reference :
Entry No. : 031 Date & Time : 08/01/2020 20:51‘O’ Clock
4. Type of Information : Written
5. Place of Occurrence :
1.(a)Direction and distance from P.S. : East, 4 K.M
Beat No. :
(b) Address : District-_________, U.P.
(c) ln case, outside the limit of this Police Station, then :
Name of P.S. : District(State) :
6. Complainant / lnformant :
(a) Name : __________
(b) Father’s Name : __________
(c) Date/Year of Birth: (d) Nationality : Indian
(e) UID No. :
(f) Passport No. :
Date of Issue. :
Place of Issue :
(h) Address :
| S. No. | Address Type | Address |
| 1 | Present Address | ——— |
(i) Phone number : __________ Mobile :+xxxxxxxxxx
7. Details of known/suspected/unknown accused with full particular:
Accused More Than:
| S.No | Name | Alias | Relative’s Name | Address |
| 1 | __________ | Father name: __________ | __________ |
8. Reasons for delay in reporting by the complainant/informant :
9. Particulars of properties of interest :
| S. No. | Property Category | Description | Value (In Rs/-) |
10. Total value of property stolen (ln Rs/-)-:
11. Inquest Report / U.D. case No. lf any :
| S. No. | UIDB Number |
12. First information contents :
To the honorable Prime Minister Govt. of India, South blocks New Delhi. Sub :- Complaint against __________ S/O __________, R/o __________, sir, It is most respectfully submitted that after any respected complaint to S.S.P. (Place) and S.H.O. (Place), I have not yet got any fruitful result from any corner. As a result of which I have lost mental peace because the above mentioned persons property dealers have grabbed approx. Rs. 1200000.00 (twelve lakh) against a plot and no ownership has been given to me. I am enclosing herewith the relevant complaint/documents to U.P. Police which is self-explanatory. Now I appeal your good self to ask the U.P. Police to take a strong action against the aforesaid property dealers to refund the money with interest to me without any delay. Date-8/1/2020, ends:- as stated yours faithfully sd. __________ S/o __________ R/o House no- __________.
नोट – मैं C/C 2100 __________ प्रमाणित करता हूं कि, तहरीर अंग्रेजी की नकल चिक हाजा पर शब्द ‘व‘ शब्द अंकित की गयी है।
13. Action taken: Since the above information reveals commission of offence (s) u/s as mentioned at Item No.2.
(1) Registered the case and took up the investigation : or
(2) Directed (Name of I.O.) : CO
Rank : Dy. SP (Deputy) No. : xxxxxxxxx
to take up the Investigation
(3) Refused investigation due to :
or
(4) Transferred to P.S. District
on point of jurisdiction
F.l.R. read over to the complainant / informant, admitted to be correctly recorded and a copy given to the complainant/ informant free of cost.
R.O.A.C.
14. Signature/Thumb impression of the complainant/ informant.
15. Date and time of dispatch to the court:
Signature of Officer in charge, Police Station
Name: PS Civil Lines
Rank: I (Inspector)
Mo. No. : xxxxxxxxxx
