SCHEDULE - I FORM NO. I Form and manner - Domestic Incident Report under Section 9 (b) and 37 (2) (c). 1. Name of the complainant/aggrieved person 2. Address 3. Mode of transmission of complaint Oral/verbal Writing 4. Nature of complaint (brief gist) (Enclosed copy of the complaint) 5. Name/Address of the respondent 6. Person to whom information first communicated. 7. Report recorded by:- protection officer/ service provider ------------------ 8. Designation/address (Signature/thump impression of complainant) (Counter signature of SP/PO) Complaint Received by: 1. Name/designation of Protection Officer 2. Address 3. Whether the complaint is covered under Section 3 (a)(b), (c) (d) of the Act. Yes …?No … Signature of Protection Officer Copy forwarded to:- 1. Local police station 2. Service provider 3. Complainant 4. Magistrate |