HIGH COURT OF DELHI: NEW DELHI

(ofice of State Court Management Systems Committee)

NI ACT COMPLAINT META DATA

(To be filled by Complainant)

A. Particulars of Complainant: Orasumen dra Kumc]haK

1. Name:
2. Gender (Male/Female/Others/Legal Entity): Male.
Age:
4. Parentage:
In case, complaint is filed through other person - Name of Authorized
5.
Representative/ Powerof Attorney Holder:
Address:
Mobile No:
246FloorsAsbuhfue,
A24floor Pat 3,Sec3s
dab ad, Hayaroa
Email ld:
Status of Complainant, if other than individual (Company/Firm/other)
details of Documents filed (Company Master Data, Form 32 for
Directors, Partnership Deed,any other:
10. Details of the advocate ofthe Complainant: (Name, enrolment ID, Raghouerdro P. SivAbiskeK Sokoran
Mobile no., emailid): 96303H423 Bhauaya Mayy 08
11. Name of Complainant'sBank where cheque was presented: oonceptleqal
i. Address ofthe Bank Branch: iroxroheral.tóm
i. IFSC Code: JD re12/2»ol, DR/26

B. Details of Accused(Add additional templates asperneed):

1. Name: Mr Y.P Shahma
2. Gender (Male/Female/Others): Mal
3. Age:
4Parentage:
5. Address: ynamí Tus kauds 55 2 0
6. Mobile No: LakshmOn Üikad,
7. Emailld: JPhase Gurqaen
Hyano 2oo1
C. Details where accused is a Company/Firm:
1. Name Dyname. lausklouels
Registered address: SS9|2l0Lakshmae Uiha, Phase 1;
3. Name of Managing Director/Partners: GuraenHay ana
4. Name ofsignatory of dishonoured cheque: 22001
5. Name of personsvicariouslyliablefor the Company/Firm:

D. Details offinancialliability(Loan, sale ofgoods/services,lease/license&others:

1. Nature of liability for which cheque was received: Sale osds Seuices
2. Incases of friendly loan, provide the following particulars:
i. Date when the borrowerapproached the Complainant forloan:
ii. Date when theloan was advanced:
i. Place at which the loan wasadvanced:
iv. Personsin whose presence the loan was advanced
V. Mode of advancement of loan (cash/ cheque/ Bank transaction/
others):
Useseparatetemplates depending upon the nature ofliability.

E. Particulars of Cheque(Add additionaltemplates asperneed);

1. Cheque Number:
2. Date onthe cheque: eb 2|Dec 202
3..Amount(in figure) on the cheque 965O S
Amount (in words) on the cheque: Iineky Six Thusort euen

Huded
5170
S. Date when the Complainant received the cheque from 3en2022 Dec,2o2|
5. Name of the Bank on which the dishonoured cheque is
acused:
i. Address of the Bank Branch:
drawn:
ii. IFSC Code:
ae, Deh,
BA Phalops, caraunt bo01
7.Datewhen the cheque was presented to the Bank lastly: L&ooodoo
8. Number of times this cheque was presented: 29 lan,2022
9.Dateon Cheque Return Memo:
10. | Date when information about dishonour was received by the 1leb 2022
Complainant: ar 2 2022
11. | Reason(s) for dishonour of cheque:
Iunds rsulair ier
F. Particulars of Legal Demand Notice:
1. Date on Legal Demand Notice:
2. Date when the Legal Demand Notice was dispatched: 16.o2.2022
3. Mode of dispatch of Legal Demand Notice H4-09.2022
(Physical/Electronic)
[personál, Speed post, Regd. Post, Courier, E-mail, othersj: Ceuu
4.Whether the Complainant relies on presumption of law for service:
5. 1f not, the actual date of service of Legal Demand Notice:
6. Whether reply to Legal Demand Notice was received: 4.o2-2022
(Yes/No)
7. If Yes, provide the date of receiving of reply:

G. Additional particulars of criminal complaint:

| 1.. Date when the 15 days from service of Legal Demand Notice was
complete: G.03.2o22
Date of accrual of cause of action:
3.Date when the limitation of one month expires:
4Whetherthe complaintisfiled withinlimitation: (Yes/Nd
5. If No, whether the Complainant is filing condonation application:

H. Other Details:
1. Name of PS within which the offence is committed:
2.
Whether any other case
fled/pending with respecttothe transaction (Yes/No
in question/cheque:
3 IfYes,the detailsthereof (CNR Number be mentioned)
4. Whether you want the
remittance/paymentbythe accusedinthe
5.
aforementioned accountof yoursas mentioned above (es/No):
if no, the No: of the account, Name of the Bank, Address of the Branch,
IFSC Code of thebranch inwhich youwant theremittance/payment:
6. Court fee paid: F3320
7. Mode of payment ofsuchcourt fee: Stamph-
I.Recourse to ADR:
1.Complainant willing tosettle by Mediation/ Lok Adalat: (Yes/ No)

J. Supporting documents:
1. Number ofdocumentsattached in e-file:
2. Particulars of documentsso attached: is heaed Chealue Cheau Pe hon
3. Undertaking oftheComplainant for filing original documents:
ql Nota, Status
deu nshce

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