e¨cK ¶gZv m¤úbœ Avg †gv³vi bvgv `wjj

µwgK bs t ewn bs t `wjj bs t ZvwiL t

‡iwRóªx Awd‡mi bvgt wLjMvuI mve †iwRóªx Awdm, XvKv|

`wj‡ji cÖK…wZ ‡gŠRvi bvg BDwbqb/IqvW© _vbv/Dc‡Rjv ‡Rjv
AcÖZ¨vnvi‡hvM¨
‡Mvovb 2bs IqvW© wLjMvuI XvKv
Avg-‡gv³vi bvgv `wjj

Avg †gv³viK…Z m¤úwËi weeiY ‡kªYx cY g~j¨ (cÖ‡hvR¨ b‡n)

‡gvU Rwg t ........................ AhyZvsk| f~wgi g~j¨- UvKv,
evox f~wg mvBwbs gvwb- UvKv, GKz‡b
Avg †gv³viK…Z m¤úwËi cwigvb t
†gvU- (
.............. (.........................)AhyZvsk|
) UvKv gvÎ|

01| `wjj m¤úv`‡bi ZvwiL t

Bs‡iRx ............... w`em .................... gvm 20...... mb|
evsjv .................. w`em ................... gvm 14....... mb|
 cvZv-

02| cvIqvi `vZv/`vZvM‡bi bvg I cwiwPwZ t

(1) bvg t
wcZvi bvg t
gvZvi bvg t
Rb¥ ZvwiL t
ag© t Bmjvg
‡ckv t M„wnbx
RvZxqZv t evsjv‡`kx
RvZxq cwiPq cÎ bs t
B-wUb t
¯’vqx wVKvbv t

eZ©gvb wVKvbv t

03| cvIqvi MÖwnZv/MÖwnZvM‡bi bvg I cwiwPwZ t

......................................... wjwg‡UWÓ GKwU †W‡fjcvi I wi‡qj G‡÷U †Kv¤úvbx hvnv †Kv¤úvbx
AvBb 1994 Gi Aax‡b MwVZ GKwU wjwg‡UW †Kv¤úvbx (hvnvi wbeÜb bs-wm-............., hvnvi cÖavb
Kvh©vjq, ..........................................., cÖwZwbwa‡Z¡ Bnvi e¨veš’vcbv cwiPvjKt
bvg t
wcZvi bvg t
gvZvi bvg t
Rb¥ ZvwiL/eqm t
ag© t
‡ckv t e¨emv|
RvZxqZv t evsjv‡`kx
RvZxq cwiPqcÎ b¤^i t ..................................................|
B-wU.AvB.Gb t .................................................|
¯’vqx wVKvbv t ....................................................
 cvZv-

04| cvIqvi `vZv Ges cvIqvi MÖwnZv Df‡qi RvZxq cwiPq‡Îi ev Rb¥ wbeÜb mb‡`i ev cÖ‡hvR¨ †ÿ‡Î,
cvm‡cv‡U©i b¤^i mn Dnvi d‡UvKwc t
cvIqvi `vZvM‡bi RvZxq cwiPq cÎ bs t

cvIqvi MÖwnZvi cwiPq cÎ bs t

.................................. wjwg‡UWÓ
cÖwZwbwa‡Z¡ Bnvi e¨veš’vcbv cwiPvjKt
........................................ Gi RvZxq cwPiq cÎ bs-.............................|

05| `wj‡ji cÿM‡bi AwfcÖvq cÖwZdj‡bi cÖ‡qvRbxq Z_¨vw`mn cvIqvi KZ…©K cÖ‡`q we‡kl, mvavib
ev AcÖZ¨vnvi‡hvM¨ ÿgZv Ges cvIqvi MÖwnZvi KZ…©K m¤úvw`Z `vwqZ¡ I KZ©e¨mg~‡ni we¯ÍvwiZ weeib t
eZ©gv‡b Avgiv AÎ `wjj `vZv I `vÎxMY Avgv‡`i mvsmvwiK bvbvn KvR K‡g© e¨Zxe¨¯Í _vKvq
Avgv‡`i D³iƒ‡c AwR©Z Zdwm‡j ewY©Z f~wg‡Z wbg©vY KvR Kwi‡Z cvwi‡ZwQbv| d‡j Avgiv `wjj `vZv I
`vÎxMY Zdwmj ewY©Z f~wg‡Z GKwU eûZjv feb wbg©v‡bi wm×všÍ MÖnY Kwiqv wbgœ Zdwmj ewY©Z m¤úwËi
†`Lvïbv, iÿbv-†eÿb, kvmb msiÿb, AvevwmK feb wbg©vY, †ePv weµx, cwiPvjbv I ch©‡eÿb, mKj
cÖKvi n¯’všÍi mn hveZxq Kvh©vw` cwiPvjbv Kwi‡Z cvwi‡ZwQ bv weavq Avgv‡`i c‡ÿ Avg-‡gv³vi wb‡qvM
Kivi GKvšÍ Avek¨K nIqv Avgv‡`i GKvšÍ wek¦¯Í I cig wn‰Zwl, mr I Kg©V-Òn¨v‡fb Iqvì© †cÖvcvwU©R
wjwg‡UWÓ cÖwZwbwa‡Z¡ Bnvi e¨veš’vcbv cwiPvjKt Avwkl Kzgvi †`ebv_-‡K Avgv‡`i AvBbMZ Avg-
‡gv³vi wb‡qvM Kwiqv cÖ‡qvRbxq I wbb¥ ewb©Z Kvh©vejx cwiPvjbv Kivi Rb¨ me©gq ÿgZv Ac©b Kwijvg|

t wbhy³xq Avg- †gv³v‡ii ¶gZvejx wbgœiƒc t

01| Avgv‡`i wbhy³xq Avg-‡gv³vi mv‡ne wbgœ Zdwmj ewb©Z m¤úwË ivRavbx Dbœqb KZ…©cÿ (ivRDK),
mswkøó Ab¨vb¨ miKvix Ges Ab¨vb¨ h_vh_ ms¯’vi Aby‡gv`b mv‡c‡ÿ ..............Zjv wewkó AvevwmK
feb wbg©vY Kivi Rb¨ Pzw³ †gvZv‡eK hveZxq Kvh© Kwi‡Z cvwi‡eb|
 cvZv-

02| Avgv‡`i wbhy³xq Avg-‡gv³vi mv‡ne wbgœ Zdwmj ewY©Z m¤úwˇZ ivRavbx Dbœqb KZ…©cÿ
(ivRDK), mswkøó Ab¨vb¨ miKvix KZ…©cÿ Ges mswkøó Ab¨vb¨ h_vh_ ms¯’vi Aby‡gvab mn mKj
miKvix, Avav miKvix Awd‡m †hvMv‡hvM Kwiqv eûZj wewkó AvevwmK feb wbg©vY Kwi‡Z cvwi‡eb|
D³ m¤úwË I BgviZ wbg©v‡Yi Rb¨ cÖ‡qvRbxq †jvKej wb‡qvM Kwi‡Z cvwi‡eb|

03| Avgv‡`i wbhy³xq Avg-‡gv³vi/†Kv¤úvbx Zdwm‡j ewb©Z m¤úwˇZ ................Zj wewkó BgviZ
wbg©vY Kwiqv wbwg©Z Bgvi‡Zi Zdwmj-L f~³ m¤úwZi ............% Ask d¬¨vU Ges bxP Zjv .........%
Ask Mvoxi cvwK©s Gwiqv wewfbœ †µZvc‡ÿi wbKU weµq Kwi‡Z cvwi‡eb Ges weµxZ d¬¨vU¸wji evqbv
bvgv `wjj, mvd Kejv `wjj mn hveZxq Kvh©¨ m¤úv`‡b †iwRwóª Kwiqv w`‡Z cvwi‡eb|
04| Avgv‡`i wbhy³xq Avg-‡gv³vi mv‡ne wbgœ Zdwmj ewY©Z f~wg‡Z wbwg©Z AvevwmK fe‡b Avgiv 2q
cÿ AÎ Avg-‡gv³vi `vZvM‡Yi cÖvc¨ Ask Ges wnm¨v Abyqvqx 2q c‡ÿi Zdwmj ewY©Z f~wg †Kvb
cÖKvi n¯ÍvšÍi Kwi‡Z cvwi‡eb bv| Z‡e wbgœ Zdwmj ewY©Z f~wg‡Z wbwg©Z AvevwmK fe‡b 1g cÿ AÎ
Avg-‡gv³vi `wjj MÖwnZvi cÖvc¨ Ask `vb, †nev, weµq, KU, †i‡nb, eÜK, weµ‡qi Rb¨ evqbve×
mn, mKj cÖKvi n¯ÍvšÍi I ˆea Pzw³‡Z Ave× nB‡Z cvwi‡eb Ges weµ‡qi D‡Ï‡k¨ weÁvcb cÖPvi
Kwi‡Z cvwi‡eb| AvevwmK d¬¨vU mn KvicvwK©s weµ‡qi Rb¨ eywKs gvwb MÖnY Kwi‡Z cwi‡eb Ges
GK ev GKvwaK bv‡g mve-Kejv `wjj m¤úv`b Kwiqv w`‡Z cvwi‡eb|
05| Zdwmj ewY©Z m¤úwË wel‡q KLbI †Kvb cÖKvi weev` †`Lv w`‡j wKsev †Kvb cÖKvi gvgjv †gvKÏgvi
D™¢e nB‡j ev gvgjv †gvKÏgvi Avek¨KZv †`Lv w`‡j Avgv‡`i wbhy³xq Avg-‡gv³vi mv‡ne
Avgv‡`i e-Kj‡g Zvnvi wbR bvg mwn ¯^vÿi m¤úv`b Kwiqv gvgjv cwiPvjbv Kwi‡Z cvwi‡eb,
AvBbRxex wb‡qvM Kwi‡Z cvwi‡eb Ges †gvKÏgvq mvÿ¨ cÖ`vb mn mKj cÖKvi c`‡ÿc e‡j
cwiPvjbv Kwi‡Z cvwi‡eb|
06| Avgv‡`i wbhy³xq Avg-‡gv³vi Avgv‡`i bvg e-Kj‡g mwn Kwiqv feb wbg©v‡Y hveZxq Kvh©vejx
cwiPvjbv Kwi‡Z cvwi‡eb Ges D&³ fe‡bi cvwb, M¨vm, we`y¨r mn hveZxq BDwUwjU mvwf©‡mi ms‡hvM
MÖnY Kwi‡eb|
07| Avgv‡`i wbhy³xq Avg-‡gv³vi wbgœ Zdwmj ewY©Z m¤úwˇZ mKj cÖKvi Dbœqb I ms¯‹vi gyjK Kvh©
Kwi‡Z cvwi‡eb Ges Ki, †nvwìs Ki BZ¨vw`i e¨vcv‡i c`‡ÿc MÖnY Kwi‡eb|
08| Avgv‡`i wbhy³xq Avg-‡gv³vi Avgv‡`i c‡ÿ wbgœ Zdwmj ewY©Z m¤úwˇZ feb wbg©v‡Yi ¯^v‡_©
m¤úvw`Z Pzw³cÎ `wjj †gvZv‡eK †h mKj KvR Kwi‡eb Zvnv AweKj Avgv‡`i KvR ewjqv MY¨
nB‡e|
 cvZv-

09| Avgv‡`i wbhy³xq Avg-‡gv³vi mv‡ne wbgœ Zdwmj ewY©Z f~wgi Dci ivRavbx Dbœqb KZ©„cÿ
(ivRDK), mswkøó Ab¨vb¨ miKvix KZ©„cÿ Ges mswkøó Ab¨vb¨ h_vh_ ms¯’vi Aby‡gv`b mv‡c‡&ÿ
eûZj wewkó AvevwmK fe‡b Zvnvi cÖvc¨ †d¬vi Gwiqv, Z`vbycvwZK f~wg Ges Kvi cvwK©s †¯úm
e¨ZxZ †Kvb Ae¯’vq Avgv‡`i wØZxq c‡ÿi (Rwgi gvwjK‡`i) cÖvß †d¬vi Gwiqv, Z`vbycwZK f~wg
Ges Kvi cvwK©s †¯úm Ask weµq I n¯ÍvšÍi Kwi‡Z cvwi‡eb bv Ges eÜK w`‡q †Kvb cÖKvi FY
MÖnY Kwi‡Z cvwi‡eb bv|

10| 1g cÿ Òn¨v‡fb Iqvì© †cÖvcvwU©R wjwg‡UWÓ Zdwmj ewb©Z m¤úwËi Dci wbg©vb KvR Kivi ¯^v‡_© †h
†Kv‡bv Zdwmwj e¨vsK, A_© cÖ`vbKvix ms¯’v wKsev nvDR wewìs dvBb¨vÝ Ki‡cv‡ikb †_‡K Zdwmj
ewY©Z Zvi cÖvc¨ As‡ki d¬¨vU I f~wg Ges M¨v‡i‡Ri Ask eÜK ‡i‡L (3 bs Aby‡”Q` †gvZv‡eK) FY
MÖnb Kivi AwaKvi _vK‡e Ges D³ †jvb/Fb 1gcÿ wbg©vZv cÖwZôvb Gi c‡ÿ Bnvi e¨e¯’vcbv
cwiPvjK, Avwkl Kzgvi †`ebv_ cwi‡kva Ki‡Z eva¨ _vK‡e| FY MÖnb Kv‡j †Kvb cÖKvi mwn
¯^vÿ‡ii cÖ‡qvRb n‡j Avg- †gv³vi `vZvMY wbg©vZv cÖwZôvb Òn¨v‡fb Iqvì© †cÖvcvwU©R wjwg‡UWÓ
Gi c‡ÿ Bnvi e¨e¯’vcbv cwiPvjK, Avwkl Kzgvi †`ebv_ H mg¯Í Kvh©¨vw` m¤úbœ Ki‡eb | Z‡e H
me F‡Yi Rb¨ Avg †gv³vi bvgv `wjj `vZvi †Kvb cÖKvi `vq-`vwqZ¡ _vK‡e bv |

06| ¯’vei m¤úwË weµq, weµ‡qi Pzw³ ev Fb MÖn‡bi wewbg‡q eÜK cÖ`vb msµvšÍ ÿgZv cÖ`Ë nB‡j
Dnvi weeib mn m¤úwËi Zdwmj eY©bv A_ev f~wg Dbœqb msµvšÍ †Kvb ÿgZv cÖ`Ë nB‡j Dnvi weeib I
Dnv‡Z m„wRZe¨ cø‡Ui ev wbwg©Ze¨ fe‡bi we¯ÍvwiZ weeib mn m¤úwËi Zdwmj eY©bv A_ev f~wg Dbœqb
e¨ZxZ ¯’vei m¤úwËi e¨e¯’vcbv msµvšÍ †Kvb ÿgZv cÖ`Ë nB‡j Dnvi weeibmn m¤úwËi Zdwmj eY©bv t
Avg †gv³viK…Z m¤úwË gvwjKvbvi cwigvb t
 cvZv-8

Zdwmj cwiPq

cvZv-

07| f~wg Dbœqb msµvšÍ †Kvb ÿgZv cÖ`Ë nB‡j, cÖ¯ÍvweZ f~wg Dbœqb Kvh© m¤ú‡bœi ci Dnv nB‡Z AwR©Z
†h Ask cvIqvi MÖwnZv cøU, BgviZ ev †¯úm AvKv‡i weµq ev n¯ÍvšÍ‡ii ÿgZvcªvß nB‡eb Dnvi weeib t
wbwg©Ze¨ d¬¨v‡Ui 1g cÿ Iqvwik‡`i gv‡S Ges 2q c‡ÿi gv‡S e›U‡bi ZvwjKv wb¤§iæc:-
Zjv wm wW
L Zdwmj
10g Zjv
9g Zjv
8g Zjv
7g Zjv
6ô Zjv
5g Zjv
4_© Zjv
3q Zjv
2q Zjv
bxP Zjv Kvi cvwK©s‡¯úm 50 Rwgi gvwjK I 50 †W‡fjcvi cÖvß nB‡e|
Zdwm‡j ..................... d¬¨vU I ........% Kvi cvwK©s †W‡fjcvvi weµq Kwi‡Z cvwi‡eb|
08| cÖ‡hvR¨ †ÿ‡Î AvB‡bi aviv 2(2) Abymv‡i m¤úwËi cbg~j¨ t
f~wgi g~j¨-.........................../- UvKv, mvBwbs gvwb-........................./- UvKv, GKz‡b †gvU-
................................../-(......................................)UvKv gvÎ|

09| cÖ‡hvR¨ †ÿ‡Î cvIqvi `vZv KZ…©K MÖnxZ †Kvb A_©, hw` _v‡K ev †Kvb Avw_©K †jb‡`b hw` nq, Z‡e
Dnvi weeib t cª‡hvR¨ bq|

10| Avw_©K `vq I `vwqZ¡, hw` _v‡K, Dnvi weeib t cÖ‡hvR¨ bq|

11| cÖ‡`q ÿgZv cÖ‡qv‡Mi wbw`©ó †gqv`, cÖ‡hvR¨ †ÿ‡Î t ............... ermi|
12| cvIqvi `vZv GKvwaK nB‡j Zvnviv †hŠ_fv‡e, ev c„_Kfv‡e ÿgZv cÖ`vb Kwiqv‡Qb wKbv Dnvi
weeib Ges wbhy³ A¨vUwb© GKvwaK nB‡j Zvnviv †hŠ_fv‡e ev c„_Kfv‡e A_ev †hŠ_ I c„_K Dfqfv‡eB
Kvh© m¤úv`‡bi ÿgZv cÖvß nBqv‡Qb wKbv Dnvi weeib t mK‡j GK‡Î ÿgZv cÖ`vb K‡ib|

13| cÿM‡bi AwfcÖvq cÖwZdj‡bi wbwg‡Ë Ab¨ †Kvb Z_¨ ev we‡kl kZ©, c‡hvR¨ †ÿ‡Î t cÖ‡hvR¨ bq|

14| cvIqvi MÖwnZvi m¤§wZm~PK ¯^vÿi t

15| cvIqvi `vZvi ¯^vÿi t

1|

16| Ab~b 2(`yB) Rb mvÿxi bvg, cwiwPwZ I ¯^vÿi t

(K) bvg t ¯^vÿi I ZvwiL t
wcZvi bvg t
gvZvi bvg t
MÖvg/†ivW bs t WvKNi t
Dc‡Rjv/_vbv t ‡Rjv t

(L) bvg t ¯^vÿi I ZvwiL t

wcZvi bvg t

gvZvi bvg t

MÖvg/†ivW bs t WvKNi t

Dc‡Rjv/_vbv t ‡Rjv t
17| gymvwe`vKvix ev †jL‡Ki bvg, cwiwPwZ I ¯^vÿi (cÖ‡hvR¨ †ÿ‡Î)t
AÎ Avg †gv³vi bvgv `wjj (13) cvZvq wjwLZ I ¯^vÿx (02) Rb e‡U|

¯^vÿi t

`wjj †jL‡Ki bvg t

Awd‡mi bvg t
mb` b¤^i t
cvZv-
18| cvIqvi `vZv KZ…©K ev Zvnvi c‡ÿ cÖ`Ë njd bvgv t
ÒnjdbvgvÓ
(ivóªcwZi 1972 m‡bi 142 bs Av‡`k, 1908 m‡bi †iwR‡÷ªkb AvB‡bi Section 524(g) Ges 1882
m‡bi m¤úwË n¯ÍvšÍi AvB‡bi Section 53E Abymv‡i cÖ`Ë njdbvgv)
eivei
mve-†iwRóªvi mv‡ne
.................. XvKv|
.....................................................................................................................................
............................. RvZxqZv- evsjv‡`kx, ag©-Bmjvg, †ckv- e¨emv I PvKzix I M„wnbx|
GB g‡g© †NvlYvc~e©K njdbvgv cÖ`vb Kwi‡ZwQ †h, Avwg/Avgiv evsjv‡`‡ki (ev cÖ‡hvR¨ †ÿ‡Î
Ab¨ †`‡ki bvMwiK nB‡j bvMwiK D³ †`‡ki bvg) bvMwiK|
Avwg/Avgiv †Nvlbv Kwi‡ZwQ †h,
(K) n¯ÍvšÍ‡ii Rb¨ cÖ¯ÍvweZ ¯’vei m¤úwË evsjv‡`k `vjvj (we‡kl UªvBey¨bvj) Av‡`k, 1972 (1972
m‡bi wc.I bs-98) Gi Aaxb †µv‡Ki AvIZvaxb b‡n;
(L) n¯ÍvšÍ‡ii Rb¨ cÖ¯ÍvweZ ¯’vei m¤úwË evsjv‡`k cwiZ¨³ m¤úwË (wbqš¿Y, e¨e¯’vcbv I wb®úwË)
Av‡`k, 1972 (1972 m‡bi wc.I bs 16) Gi A_©vbyhvqx cwiZ¨³ m¤úwË b‡n;
(M) n¯ÍvšÍ‡ii Rb¨ cÖ¯ÍvweZ ¯’vei m¤úwË AvcvZZt ejer †Kvb AvB‡bi Aaxb miKv‡i eZ©vq bvB, ev
miKv‡ii AbyK~‡j ev‡Rqvß nq bvB;
(N) cÖ¯ÍvweZ n¯ÍvšÍi AvcvZZt ejer Ab¨ †Kvb AvB‡bi †Kvb weav‡bi mwnZ mvsNwl©K b‡n;
(O) cÖ¯ÍvweZ n¯ÍvšÍi evsjv‡`k j¨vÛ †nvwìs (wjwg‡Ukb) Av‡`k, 1972 (1972 m‡bi wc.I bs 8) Gi
Aby‡”Q`-5G Abyhvqx evwZj‡hvM¨ b‡n; Ges
(P) n¯ÍvšÍ‡ii Rb¨ cÖ¯ÍvweZ ¯’vei m¤úwËi weeiY mwVKfv‡e ewY©Z nBqv‡Q Ges Dnv Aeg~j¨ Kiv nq
bvB Ges DwjøwLZ m¤úwË n¯ÍvšÍiKi‡Y Av‡e`bKvixi ˆea AwaKvi iwnqv‡Q|cvZv-13

Avwg/Avgiv AviI †NvlYv Kwi‡ZwQ †h,

Avwg/Avgiv n¯ÍvšÍivaxb Rwgi wbi¼zk gvwjK| Ab¨ †Kvb c‡ÿi mwnZ evqbv Pzw³ ¯^vÿi Kwi bvB ev Ab¨ †Kv_vI
weµq Kwi bvB ev Ab¨ †Kvb c‡ÿi wbKU eÜK ivwL bvB| GB m¤úwË miKvwi Lvm/Awc©Z ev cwiZ¨³ m¤úwË bq
ev Ab¨ †Kvbfv‡e miKv‡ii Dci eZ©vq bvB| `wj‡j ewY©Z †Kvb Z_¨ fyjfv‡e wjwce× nBqv _vwK‡j Z¾b¨
Avwg/Avgiv `vqx nBe Ges Avwg/Avgv‡`i weiæ‡× †`Iqvbx I †dŠR`vix gvgjv Kiv hvB‡e| n¯ÍvšÍwiZ Rwg m¤ú‡K©
†Kvb fyj, AmZ¨ ev weåvwšÍKi Z_¨ cÖ`vb Kwiqv _vwK‡j cÖ‡qvR‡b wbR LiPvq fyj ï× Kwiqv ÿwZcyibmn bZzb
`wjj cÖ¯‘Z I †iwRw÷ª Kwiqv w`‡Z eva¨ _vwKe| D‡jøL¨ `wj‡j n¯ÍvšÍixZ m¤úwËi g~j¨ Kg †`Lv‡bv nq bvB|
`wjj ewY©Z m¤úwˇZ Avgvi/Avgv‡`i ˆea ¯^Z¡ I AwaKvi envj Av‡Q Ges cÖ`Ë weeib Avgvi/Avgv‡`i Ávb I
wek¦vmg‡Z mZ¨ | ZvwiL t
njdKvix/njdKvixM‡Yi ¯^vÿi t

1|

mbv³Kvixi †NvlYvt
GB g‡g© †NvlYv Kwi‡ZwQ †h, njdKvix/njdKvixMY Avgvi cwiwPZ Avgvi m¤§y‡L wZwb/Zvnviv `wj‡j
¯^vÿi cÖ`vb Kwiqv‡Qb(ev Avwg Zvnvi ev Zvnv‡`i ev ..... bs µwgKavix njdKvixi bvg eKj‡g wjwLqv
w`qvwQ|

mbv³Kvixi ¯^v¶i t

19| mve-‡iwRóªv‡ii bvg I c`exmn ¯^vÿi I ZvwiL t