IN THE COURT OF THE

Crl.M.P.No. of 20
IN
C.C.No. of 20

Between:-

---Petitioner/third Party

And

The State of
through S.H.O. ---Respondent/Complainant

AFFIDAVIT FILED BY THE PETITIONER/THIRD PARTY

U/RULE-44 TO 47 OF Cr.R.P.

I, S/o Aged: Years,

Occu: R/o
do hereby solemnly affirm and state on oath as under:-

1. I am the petitioner herein and third party to above proceedings, hence I

know the facts of the case.

2. I submit that, I sustained injuries/my ___________ died in a Motor Vehicle

accident occurred on___________ at_____________________________________,
which falls within the limits of P.S.________________ and as such the Respondent
herein registered the above Crime and after investigation filed chargesheet in the
above C.C., I am intending to file/have filed a claim petition before the Motor
Accident Claims Tribunal for grant of compensation. I humbly submit that to prove
my claim the certified copies of documents i.e., F.I.R., along with complaint,
Chargesheet, Medical Certificate, Rough sketch of Scene of offence, Crime Details
Form, Postmortem Report, Inquest Report and M.V.I.Report etc., which are
mentioned in the copy application, are very much required.

Therefore, it is prayed that the Hon’ble Court may be pleased to permit me to

take the certified copies of documents which are mentioned in the copy application
and as prayed for in the petition, in the interest of justice.

DEPONENT
VERIFICATION:- Solemnly affirmed and signed before me by the deponent
admitting the contents of this affidavit on this day of 20
at

ADVOCATE
IN THE COURT OF THE

Crl.M.P.No. of 20
IN
C.C.No. of 20

Between:-

---Petitioner/third Party

And

The State of
through S.H.O. ---Respondent/Complainant

PETITION FILED U/RULE 212 OF Cr.R.P.

For the reasons stated in the accompanying affidavit, the petitioner/third

party prays that the Hon’ble Court may be pleased to permit the petitioner to take

the certified copies of documents i.e., F.I.R along with complaint, Chargesheet,

Medical Certificate, Rough sketch of Scene of offence, Crime Details Form,

Postmortem Report, Inquest Report and M.V.I.Report etc., which are mentioned in

the copy application enclosed herewith, in the interest of justice.

Date:- - -20 Advocate for Petitioner

IN THE COURT OF THE

Crl.M.P.No. of 20
IN
C.C.No. of 20

Between:-

---Petitioner/third Party

And

The State of
through S.H.O.

---Respondent/Complainant

PETITION FILED U/RULE 212 OF

Cr.R.P.

FILED ON:-

FILED BY:-

ADVOCATE