(ANNEXURE I)

IN THE COURT OF CHIEF JUDICIAL MAGISTRATE ………………

 
Complaint No.:_________
__________________Complainant
Versus
____________________Accused
Complaint under Section 138 of the Negotiable Instrument Act, 1881 as amended by the Act
No 66 of 1988.
Respectfully Sheweth :
1.That the complainant is presently working as ______. The respondent accused purchased
____ from the complainant.
2. That the accused issued the Cheque bearing No. ______ dated _____ for the sum of
Rs._____ drawn at bank _____to the complainant towards the consideration of the above
articles purchased from the complainant.
3. That the complainant presented the cheque through his own bankers, i.e.; _____, but the
same was returned unpaid, on ______ with the endorsement of insufficiency of funds in
account of the accused as per the remarks of the banker of the accused.
4. That other necessary particulars are as under for the convenience of this Hon'ble court:-
[a] Date of cheque                :         ______
[b] Date of presentation      :       ______
 of Cheque before the Bank (within 6 months from_____)
[c] Date of dishonour of Cheque   : ______
[d] Date of receipt of Memo of    : ______
      of dishonour of cheque
[e] Date of sending of Notice     : ______
      (within 30 days from _____)
[f]   Date of service of Notice     : ______
[g]   Date when cause of action   : ______
     arose (15 days after service
     on _______)
[h]  Date of filing complaint     : ______
      (within 1 month from ______)
5. That the accused has apparently issued the cheque without caring to ensure adequate funds
and knowing fully well with the ulterior motive to cheat the complainant.
6. The memo to that effect was duly communicated to the complainant by its banker on
______.
7.   That the said cheque drawn by the accused on an account maintained by him with the
above banker for payment of the amount of money to the complainant from out of that
account was issued for the discharge of the above said debt/liability.
8.   That the said cheque has been returned by the bank unpaid, because of the amount of
money standing to the credit of account of the accused is insufficient to honour the cheque or
that it exceeds amount arranged to be paid from that account by an agreement made with that
bank.
9. That the accused has thus committed an offence under the Act and shall without prejudice
to any other provision of the Act or any other law, be liable to  be punished with
imprisonment for a term which may extend to one year, or with fine which may extend to
twice the amount of the cheque, or with both.
10.  That the cheque has been presented to the bank within a period of six months from the
date on which it is drawn i.e.; on ______ .
11.  That the complainant in due course of the cheque, has made a demand for the payment of
the said amount of money by giving a notice in writing  to the accused within fifteen days of
the receipt of information by him from the bank regarding return of the cheque as unpaid. 
The said notice was sent on the correct address of the accused through a Registered/AD letter
as well as through UPC on _____ and the said registered letter has been received by the
accused on _____ , as is evident from the endorsement of post office seal on the AD.
12.That the accused has failed to make the payment of the amount of money to the
complainant in due course of the cheque within fifteen days of the receipt of the said notice.
13.That it is pertinent to mention here that the debt/liability, for which the cheque was issued
by the accused to the complainant is a legally enforceable debt/liability.
14.That the complainant is making this complaint in writing, in due course of the cheque,
before this Hon'ble court for taking the  cognizance of the offence committed by the accused
which is punishable under Section 138 of the Act.
15. That this complaint is made within one month of the date on which the cause of action
has arisen under clause (c) of the proviso to Section 138 of the Act.
16. The prosecution of the accused shall be sought under 138 of the Negotiable Instrument
Act, 1881 as amended by the Act No. 66 of 1988, under the provisions of which a notice was
sent by the Regd post and UPC at the correct address of the accused.
17.  That the offence has been committed within jurisdiction of this Hon'ble court.
18.   It is, therefore, most respectfully prayed that the accused may be summoned to face trial
for the offence under section 138 of the Negotiable Instruments Act and be punished to the
maximum of imprisonment and imposed a fine twice the amount of the cheque in accordance
with the law in the interest of justice.  Such other orders be also passed as deemed fit and
proper in the facts and circumstances of the case in favour of the complaint and against the
accused.
FOR THIS ACT OF KINDNESS, THE COMPLAINANT, AS IN DUTY BOUND SHALL
EVER PRAY.
(Name of Place)                                                                          Complainant
______                                                                                    Through, Advocate
 
 
 
IN THE COURT OF CHIEF JUDICIAL MAGISTRATE ……………
 
Complaint No.:_________
___________________Complainant
Versus
____________________Accused
Preliminary Evidence by the Complainant by way of Affidavit in support of Complaint under
Section 138 of the Negotiable Instrument Act, 1881 as amended by the Act No 66 of 1988.
Respectfully Sheweth :
    I, ______, do hereby solemnly affirm and declare as under:-
1. That I am a _____.  The respondent accused purchased _____.
2. That in discharge of the liability the accused issued me the Cheque (Exhibit CW-1/A)
bearing No. ______ dated _____ for a valuable consideration of Rs. _____ drawn at bank
______.
3. That I presented the said cheque through my banker, ie; _____ on ______, but the same
was returned unpaid to me on ______ (Vide Exhibit CW-1/B) with the endorsement of
insufficiency of funds in account of the accused.
4. That the accused has apparently issued the cheque without caring to ensure adequate funds
and knowing fully well with the ulterior motive to cheat me.
5. That the said cheque drawn by the accused on an account maintained by him with the
above banker for payment of the amount of money to me out of that account was issued for
the discharge of the above said debt/liability.
6. That the said cheque has been returned by the bank unpaid, because of the amount of
money standing to the credit of account of the accused is insufficient to honour the cheque
___or that it exceeds amount arranged to be paid from that account by an agreement made
with that bank.
7. That the accused has thus committed an offence under the Act and shall without prejudice
to any other provision of the Act or any other law, be liable to  be punished with
imprisonment for a term which may extend to one year, or with fine which may extend to
twice the amount of the cheque, or with both.
8. That the cheque has been presented to the bank within a period of six months from the date
on which it is drawn ie; on _____.
9. That I in due course of the cheque, have made a demand for the payment of the said
amount of money by giving a notice dated ______ (Exhibit CW-1/C) in writing  to the
accused within thirty days of the receipt of information by me from the bank regarding return
of the cheque as unpaid.  The said notice was sent on the correct address of the accused
through a Registered/AD (Exhibit CW-1/D) letter as well as through UPC (Exhibit CW-1/E)
on ______ and the said registered letter has been received by the accused as the AD (Exhibit
CW-1/F) has been received back duly signed.
10. That the accused has failed to make the payment of the amount of money to me in due
course of the cheque within fifteen days of the receipt of the said notice.
11. That the debt/liability, for which the cheque was issued by the accused to the complainant
is a legally enforceable debt/liability.
12. That I filed this complaint in writing, in due course of the cheque, before this Hon'ble
court for taking the  cognizance of the offence committed by the accused which is punishable
under Section 138 of the Act.
13. That this complaint is made within one month of the date on which the cause of action
has arisen under clause (c) of the proviso to Section 138 of the Act.
14.  The prosecution of the accused is sought under 138 of the Negotiable Instrument Act,
1881 as amended by the Act No. 66 of 1988, under the  provisions of  which a notice was
sent by the Regd post and UPC at the correct address of the accused.
15. That the offence has been committed within jurisdiction of this Hon'ble court.
16. That the accused be tried and punished for the said offence.
Deponent
Verification:
        I, the above deponent, do hereby verify that the contents of paras 1 to 16 of the above
affidavit of mine are correct and true and no part of it is false and nothing material has been
concealed therein.
          Verified here at (Name of Place) this  the day of ________.
 Deponent
List of Documents Filed
1. Original Dishonoured Cheque bearing No. _______dated________
to be drawn on ________ Bank
2. Original Memo of Bank dt ________
3.  Copy of Notice issued to the accused dated ________
4.  Original Receipts of Registry/UPC & AD.
5.   Original unclaimed Registered Letter.
                                                                                                            Sign
List of Witness
1. Complainant
2. Officials concerned of both the banks, ie; drawer Bank _____ and drawer Bank _____
along with the relevant records pertaining to the account of the accused and the dishonoured
cheque.
3. Official concerned of the Postal department of Post Office ______
(Name of Place)                                                                          Complainant
_____                                                                                      Through, Advocate
                              
  Process Fee
In the Court of : Chief Judicial Magistrate, …………….
                                          ______ Versus   ______
Claim : Complaint
Date of Hearing: ______
 
Date
By Whom Filed
Purpose
Amount
Stamp
 
 
  _____ 
Complainant   For service of the accused
                                                              Advocate
Received on ______ Court-fee stamp of the value of Rs. ______ with _____ copies in case
No.  _____ of 20__ in Re. ______ Vs ______.
 

Signature of the Head Notice Writer