English translation of FIR (Crime) no. /2021 of ………..

Police Station

FORM No. 1

KERALA POLICE

FIRST INFORMATION REPORT

(Under Section 154 Cr.P.C.)

1. District : P.S :
FIR No : 1549 Year : 2021
Date &Time : 05-11-2021 18:34 hrs
2.

Sl.No. Acts Sections

1 IPC 1860 420,34

3. (a) Occurrence of offence:

1. Day : Intervening Day Time Period : 00:00
Date : 13/03/2020 Date to : 05/05/2020
Time from : 00:00 hrs Time to : 00:00 hrs

(b) Information received at P.S:

Date : 05/11/2021 Time : 18:02 hrs

(c) General Diary Reference:

Entry No. : 013 Time : 18:34 hrs

4. Type of Information : Court Endorsement

Source of complainant : Court

5. Place of occurrence :

1
(a) Direction and distance from P.S : WEST, 0.7 Km
Beat No :
(b) Address :
 (c) In case outside the limit of this police station:
Name of P.S :
District :

6. Complainant/ Informant:
(a)Name :

(b)Husband’s Name :

(c) Date/ Year of Birth :

(d) Nationality : INDIA

(e) Passport No: ……...... Date of Issue: …………… Place of Issue: …………….

S.No. Id Type Id Number

(f) Occupation :

(g) Address :

S.No. Address Type Address

1 Present Address

2 Permanent Address

(h) Phone number :

(2) Victim/Missing/Deceased details:

Sl. Name Age Sex Relative’s Name Address

No
7. Details of known /suspected/unknown accused with full particulars:

S.No. Name Alias Relative’s Name Address

8. Reasons for delay in responding the complainant/Informant:

9. Particulars of property of interest:

S.No. Property Sub Type Description Value

Type

10. Total Value of Property Stolen (Attach separate sheet if necessary):

11. Inquest Report /U. D case No., If any:

S.No. Registration Type Registration Number

12. First Information Contents:

13 Action taken: (Since the above Information reveals commission of offence (s) u/s as mentioned
at Item No. 2.
 Investigation/Assign IO

Registered the case and took up the Investigation:

Name of IO :

Rank : SI (Gr) (Sub – Inspector (Grade))

PEN :

14 Signature/Thump impression of the complainant/informant Signature of office in charge,

Police Station

Name :
Ran : I (Inspector)
PEN :

F.I.R. read to the complainant, admitted to be correctly recorded and a copy given to the
complainant/informant free of cost