1. P.S.

FIR No. Date and Time of FIR

District Year

2. S.No. Acts Sections

1 147

2 148

3 149

4 307

5 323

6 332

7 336

8 353

9 186

10 188

11 504

12 427

13 7

14 2

15 3

FIRST INFORMATION REPORT (Under Section 154 Cr.P.C.)

3. (a) Occurrence of offence

Day Date from Date To 1

1

N.C.R.B

(b) Information received at P.S. Date Time

(c) General Diary Reference Date and Time Entry No.

Time Period Time From Time To

4. Type of Information

5. Place of Occurrence

Beat No.

(c) In case, outside the limit of this Police Station, then Name of P.S.

1. (a) Direction and distance from P.S.

(b) Address

District (State)

6. Complainant / Informant

(a) Name

(b) Father's Name

(c) Date/Year of Birth (d) Nationality

(e) UID No.

(f) Passport No.

Place of Issue Date of Issue

(g) ID Details (Ration Card, Voter ID Card, Passport, UID No., Driving License, PAN)

2

N.C.R.B

(h) Occupation

(i) Address

(j) Phone number Mobile

S.No. Address Type Address

1

2

7. Details of known / suspected / unknown accused with full particulars

S. No. Name Alias Relative's Name Present Address(

1

2

3

4

5

Accused More Than

S. No. ID Type ID Number

3

N.C.R.B

6

7

8

9

10

11

12

13

14

15

16

4

N.C.R.B

17

18

19

20

21

22

23

24

25

26

5

N.C.R.B

27

28

29

30

31

32

33

34

35

36

37

6

N.C.R.B

38

39

40

41

42

43

44

45

46

47

48

7

N.C.R.B

49

50

51

52

53

54

55

56

57

58

59

8

N.C.R.B

60

61

62

63

64

65

66

67

68

69

70

9

N.C.R.B

71

72

73

74

75

76

77

78

79

80

81

10

N.C.R.B

S. No. Propertty Category Property Type Description Value(In

Rs/-)

Particulars of properties of interest 9.

8. Reasons for delay in reporting by the complainant / informant

12. First Information contents

IPC

UP20AG0458

82

83

10. Total value of property (In Rs/-)

11. Inquest Report / U.D. case No., if any

S. No. UIDB Number

11

N.C.R.B

12

N.C.R.B

13

N.C.R.B

14

N.C.R.B

22

34 0 0

18

35 0 0

20

36 0

0 30

37

0 0 0

40

38 0 0

18

39 0 0 0

19

40 0 0

20

41

0 0 26

42

0 0

23

43 0 0

20

44 0 0

25

45 0 0

26

46 0

0 0 18

47

0 0

24

48 0 0

15

N.C.R.B

24

49 0 0

27

50 0 0

0 24

51

0 0 23

52

0 0

23

53 0 0

28

54 0 0 0

22

55

0 0 32

56

0 0 0 45

57

0 0

19

58 0 0

22

59 0 0

18

60

0 0 30

61

0 0

30

62 0 0

18

63 0 0

19

64 0

37

16

N.C.R.B

65 0 0

0 21

66

0 0 19

67 0 0

18 68 0 0

22 69

0 0 20

70 0 0 0

18 71

0 0 22

72 0 0 0

43 73 0 0

0 0 31 74

0 0

55 75 0 0

25 76

0 0

21 77 0 0

22 78

0 0

26 79 0 0

32 100, 150

0 0

0 0

0 0

0 0

0

0 0 0

0 0

0 0

147/148/149/307/323/336/332/353/186/188/504/427 IPC 7

2/3 1984

17

N.C.R.B

16.10

0

0

0 1610

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)

(3)

Directed (Name of I.O.) PS Nagina

Rank

No. to take up the Investigation

or

Refused investigation due to or

13.

(4) Transferred to P.S. District

18

N.C.R.B

on point of jurisdiction

F.I.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 impressionof the complainant /

informant

Signature of Officer in charge, Police

Station

Name PS NAGINA

Rank I (Inspector)

No.

Date and time of dispatch to the court 15.

Attachment to item 7 of First Information Report

Physical features, deformities and other details of the suspect/accused: ( If known / seen )

S. No. Sex Date / Year Of Birth

Build Height (cms)

Complexion Identification Mark(s)

1 2 3 4 5 6 7

1 1999 -

19

N.C.R.B

2 1997 -

3 1998 -

4 1998 -

5 1979 -

6 2001 -

7 1999 -

8 2001 -

9 1999 -

10 1996 -

11 1997 -

12 1999 -

13 1999 -

14 1992 -

15 1994 -

20

N.C.R.B

16 1999 -

17 1984 -

18 1991 -

19 1991 -

20 2001 -

21 1989 -

22 1986 -

23 1991 -

24 1991 -

25 1995 -

26 1994 -

27 1989 -

28 1994 -

29 1999 -

21

N.C.R.B

30 1995 -

31 1994 -

32 2000 -

33 1997 -

34 2001 -

35 1999 -

36 1989 -

37 1979 -

38 2001 -

39 2000 -

40 1999 -

41 1993 -

42 1996 -

43 1999 -

22

N.C.R.B

44 1994 -

45 1993 -

46 1998 -

47 1995 -

48 1995 -

49 1992 -

50 1995 -

51 1996 -

52 1996 -

53 1991 -

54 1987 -

55 1987 -

56 1974 -

57 2000 -

23

N.C.R.B

58 1997 -

59 2001 -

60 1989 -

61 1989 -

62 2001 -

63 2000 -

64 1982 -

65 2001 -

66 2000 -

67 2001 -

68 1997 -

69 1999 -

70 2001 -

71 1997 -

24

N.C.R.B

72 1976 -

73 1988 -

74 1964 -

75 1994 -

76 1998 -

77 1997 -

78 1993 -

79 1987 -

80 1995 -

81 1994 -

82 1993 -

83 1991 -

25

N.C.R.B

Deformities / Peculiarities

Teeth Hair Eye Habit(s)

(

Dress Habit

(s)

8 9 10 11 12 13

26

N.C.R.B

27

N.C.R.B

28

N.C.R.B

29

N.C.R.B

30

N.C.R.B

Language/Dialect

Place of Others

Burn Mark Leucoderma

Mole Scar Tattoo

14 15 16 17 18 19 20

31

N.C.R.B

32

N.C.R.B

These fields will be entered only if complainant/informant gives any one or more particulars about the suspect/accused.

33

N.C.R.B