Ni Act Meta Data Form
Ni Act Meta Data Form
A. Particulars of Complainant:
1. Name:
2. Gender (Male/Female/Others/Legal Entity):
3. Age:
4. Parentage:
5. In case, complaint is filed through other person - Name of Authorized
Representative/ Power of Attorney Holder:
6. Address:
7. Mobile No:
8. Email Id:
9. 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 of the Complainant: (Name, enrolment ID,
Mobile no., email id):
11. Name of Complainant’s Bank where cheque was presented:
i. Address of the Bank Branch:
ii. IFSC Code:
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5. Date when the Complainant received the cheque from accused:
6. Name of the Bank on which the dishonoured cheque is drawn:
i. Address of the Bank Branch:
ii. IFSC Code:
7. Date when the cheque was presented to the Bank lastly:
8. Number of times this cheque was presented:
9. Date on Cheque Return Memo:
10. Date when information about dishonour was received by the
Complainant:
11. Reason(s) for dishonour of cheque:
H. Other Details:
1. Name of PS within which the offence is committed:
2. Whether any other case filed/pending with respect to the transaction (Yes/No)
in question/cheque:
3. If Yes, the details thereof (CNR Number be mentioned):
4. Whether you want the remittance/payment by the accused in the
aforementioned account of yours as mentioned above (Yes/No):
5. If no, the No. of the account, Name of the Bank, Address of the Branch,
IFSC Code of the branch in which you want the remittance/payment:
6. Court fee paid:
7. Mode of payment of such court fee:
I. Recourse to ADR:
1. Complainant willing to settle by Mediation/ Lok Adalat: (Yes/ No)
J. Supporting documents:
1. Number of documents attached in e-file:
2. Particulars of documents so attached:
3. Undertaking of the Complainant for filing original documents:
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