FORM No.

(M) 3
FORM FOR RECORDING EXAMINATION OF THE ACCUSED
(Section 313 of the Criminal Procedure Code)

The examination of ________________________________ aged about ___________

years, taken before me ________________________________, Magistrate of the
_____________ of the __________________ 20 _____ in the _____________________ language,
interpreted by ______________________________
My name is ___________________________________ My father’s/husband’s name is
___________________________. I am by religion ______________________, and by
occupation ________________________. My home is at Mauza _____________________,
Police Station ___________________ District __________________, I reside at
_____________________________.

(Signature or mark of the accused)

(Signature of Magistrate)

The above examination was taken in my presence and hearing, and contains a
full and true account of the statement made by the accused.

(Signature of Magistrate)