FORM I [See Rules 5(1) and (2) and 17(3)]

Impugned Provision / other anomaly	Breach of Section / Article
FORM I Under Rules 5(1) and (2) and 17(3)	Encroach upon the Legislative Policy of the Parliament.

FORM I
[See Rules 5(1) and (2) and 17(3)]
Domestic Incident Report under Sections 9(b) and 37(2)(c) of the
Protection of Women from Domestic Violence Act, 2005 (43 of 2005)

1. Details of the complainant/aggrieved person
    (1) Name of the complainant/aggrieved person:
    (2) Age:
    (3) Address of the shared household:
    (4) Present Address:
    (5) Phone Number, if any:

2. Details of Respondents:

Sl. No.	Name	Relationship with the aggrieved person	Address	Telephone No., if any

3. Details of children, if any, of the aggrieved person:
        (a) Number of Children:
        (b) Details of Children:

Name	Age	Sex	With whom at present residing

4. Incidents of domestic violence:

Sl. No.	Date, place and time of violence	Person who caused domestic violence	Types of violence	Remarks
			Physical violence
			Causing hurt of any kind, please specify
(i) Sexual violence Please tick mark [ ] the column applicable
			□ Forced sexual intercourse □ Forced to watch pornography      or other obscene material □ Forcibly using you to entertain      others □ Any other act of sexual nature,      abusing, humiliating, degrading      or otherwise violative of your      dignity (please specify details in      the space provided below):
(ii) Verbal and emotional abuse
			□ Accusation/aspersion on your      character or conduct, etc. □ Insult for not #bringing dowry, etc. □ Insult for not having a male child □ Insult for not having any child □ Demeaning, humiliating or      undermining remarks/statement □ Ridicule □ Name calling □ Forcing you to not attend school,      college or any other educational       institution □ Preventing you from taking up a job □ Preventing you from leaving the      house □ Preventing you from meeting any      particular person □ Forcing you to get married against      your will □ Preventing you from marrying a      person of your choice □ Forcing you to marry a person of      his/their own choice □ Any other verbal or emotional      abuse (Please specify in the space      provided below)
(iii) Economic violence
			□ Not providing money for maintaining      you or your children □ Not providing food, clothes,      medicine, etc. for you or your      children □ Forcing you out of the house you      live in □ Preventing you from accessing or      using any part of the house □ Preventing or obstructing you from      carrying on your employment □ Not allowing you to take up an      employment □ Non-payment of rent in case of a      rented accommodation □ Not allowing you to use clothes or      articles of general household use □ Selling or pawing your stridhan or      any other valuables without      informing you and without your      consent □ Forcibly taking away your salary,      income or wages etc. □ Disposing of your stridhan □ Non-payment of other bills such as      electricity, etc. □ Any other economic violence      (Please specify in the space      provided below)
(iv) Dowry related harassment
			□ Demands for dowry made, please      specify □ Any other detail with regard to      dowry, please specify: Whether details of dowry items, stridhan, etc. attached with the form □ Yes □ No
(v) any other information regarding acts of domestic violence against you or your children

(Signature or thumb impression of the complainant/aggrieved person)               

5. List of documents attached

Name of document	Date	Any other detail
Medico legal certificate
Doctor's certificate or any other prescription
List of Stridhan
Any other document

6. Order that you need under the Protection of Women from Domestic Violence Act, 2005

Sl. No.	Orders	Yes/No	Any other
(1)	Protection order under Section 18
(2)	Residence order under Section 19
(3)	Maintenance order under Section 20
(4)	Custody order under Section 21
(5)	Compensation order under Section 22
(6)	Any other order (specify)

7. Assistance that you need

Sl. No.	Assistance available	Yes/No	Nature of assistance
(1)	(2)	(3)	(4)
(1)	Counsellor
(2)	Police assistance
(3)	Assistance of initiating criminal proceedings
(4)	Shelter home
(5)	Medical facilities
(6)	Legal aid

8. Instruction for the police officer assisting in registration of a Domestic Incident Report:

    Wherever the information provided in this Form discloses an offence under the Indian Penal Code or any other law, the police officer shall

(a) inform the aggrieved person that she can also initiate criminal proceedings by lodging a First Information Report under the Code of Criminal Procedure, 1973 (2 of 1974)

(b) if the aggrieved person does not want to initiate criminal proceedings, then make daily dairy entry as per the information contained in the domestic incident report with a remark that the aggrieved person due to the intimate nature of the relationship with the accused wants to pursue the civil remedies for protection against domestic violence and has requested that on the basis of the information received by her, the matter has been kept pending for appropriate enquiry before registration of an FIR

(c) if any physical injury or pain being reported by the aggrieved person, offer immediate medical assistance and get the aggrieved person medically examined

Place:                                                                             (Counter signature of Protection Officer/Service provider)
Date :                                                                                                                     Name:
                                                                                                                              Address:

(Seal)                                

Copy forwarded to:

1. Local Police Station
2. Service Provider/Protection Officer
3. Aggrieved person
4. Magistrate

My Argument

1.      Form I, inter alia, furnish illustrations which would constitute Domestic Violence. Such illustrations purport to illustrate the various forms of domestic violence recited in the definition of domestic violence in section 3 of the Act.

2.      It is submitted that defining the scope and ambit as what would constitute “domestic violence” within the meaning of Section 3 of the Act, is the Legislative Policy and prerogative of the Parliament. Further, perusal of section 37 of the Act, it would reveal that Rule making power have not been conferred upon the Central Govt in respect of section 3 of the Act.

3.      Therefore, by way of executive fiat, the scope and ambit of domestic violence cannot be further defined by the Central Govt, directly or indirectly. A thing which cannot be done directly cannot be done indirectly. The Central Govt cannot amplify the scope and ambit of “domestic violence” under the text of sections 9(b) and 37(2)(c) of the Act.

4.      It is further submitted that whereas the breach of protection of Order, thereby restraining the Respondent from committing any act of domestic violence, postulates a criminal offence upon the Respondent, it would be impermissible to amplify the ambit and scope of legislative Policy which is contained in section 3 of the Act.

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