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ITFOKMATIOI'I REPORTcf*Ff] s{r .F.ogm_-J.-A

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Name of P.S.Dist.:A--*tulgFi

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Compiainantdqt]l.rEl-{ / isE{i

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#'" qf;/lnformant :

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F-ather'k'-qr? IDate/Y(cj

ar1{f til{frqrband's Namt:I

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iic'zni €qrtr

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ffiH**--!1/*#" a"lfiIl

{e i Fassport No. : ....."... ... Date of Issr-re ; .,!l$ft th- ftcqr.j] fit-€rc"r

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CI0A7 42Lt\

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n Deformities f Pec uliaritiesq'T / tRId

{7)

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nDress HabitsdttlglqsqS

(12\(B) (e) t10) {11)

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Languages/ Dialect

rriqr / qH Erql

(13)

PLACE OF----_|.."Burn Mark |

*Leucoderma

xiTq-dTfr Wr I -I"---r-----(14) I (1s)

*Mole-a-Q ICO

*ScarqnT

*TattoorilE-tl

(16) (r7) (18)

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I

L-_-_- -----lrese riercts r,vi11 rrc entcred onlv 1f

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X*;+f**pf*ffi*ffi ' *':*T .'.'* .

:::' : :'A rJai:rrrase r:reliated, rvill subsequcirtll,'link r:rrr' :;r.rsp{:ft i11 s;"rrt:l'rtl l''M*t':' 1{ i:i'i'1.'

Forrn: l-C

r,,: i",r 4 ;t 4.ii."1ing by the ComPlainant/informant :

R-ciqt-frorEo) 'No,

Particularsofpropertiesstolen/involved(Attach.".j"'.l3sheet,ifnecessarl'):d€I1 lHaqT/ 3lf,-fd {r|dq+il dqPftd (enoru6 3f€-sTftl', €dT 6r-qq rlt"qql)

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for delaY inq{qtl il*r+_ff{u

t1

12,.

10. *Totalvalue of properties stolen/invoh'ed : """" """"':"'

dtqr td.eql/Gm{d qTaqid Tftt {@ :

U. D. Case No.' if anY:

r-r,/s as mentioned at ltemActioi-takenYSrnce tne aoovc rcl-'ur \. r'

No. 2, registered tL. ";;; ""4 i""li t-tp the investigation/directed", ;";;;.ro *t"in.,"u,ig",i"*

Signature/ Thumb imPressron

of the ComPlainant/ info:-mant'

dm<RT*/sqft* srfi i3i'16sru 6sT

Date & Time of despatch tL: the court : " " "

oteio qioM arfte q d'o

-l i ilill::::: :T::::::: ::iffi,:: to

'iake up

'fhe inves'iisa'fion/

Refusecl investigation/transferred to P' S"' """"""""""on point ofjuriscliction'

;66 t5pffi : qTq fr, ? ntt;rr5 a-&-csl o-d-]r'q"$.,q."q q.€-oq]i qfta ersqrflE{q fuqc a]lFqT5-e gql"i ffi;irFi

ilrqrAoTqEffiiir&q(rl|..'.qmdqrqlao]qflfrnTqE]n-{iifuarlqqma-{Tqdflor.rdleft+rfti_.{

........ cffiT er"qre-3 fl<Tilftd Ate'

fTo ,""0 """r," in" ;";oi;;";r.ilr^tor*unt /admittecl to be correctll'recorded and a cop5'

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14.

Statiort

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'G !' ' 'u '"' ft Filrm l:&i:s ,t , i- lt 6'.t

IF,' ii I& s .,,, )* I cRlMtr DETAILS FORM j r',1.,.,,.,,,, If \r' "-''t -'I

rwran aqvfi-drql'rgcT

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it#t;H",' *'79" s'sx rr7s1; e;.* . az" 4;;u; 'i z 4,f i'ti fi:ar fi " III

The Place of Occurrence shown bY : I

Iqe+A B-mTUt ErtqM:lrlama. qP A rt n

H'""' ;+V'"b;,2'a'3' -.-;Fe z/gu,, tffiffiH:*"'n"' *is,rp -.-F o'H- |

Address: ,.&=_^a..;.fi..:.;.;;.1...:;;.;;;rf..,4^....ii.J.;...;. f al-9*,t eA, ;;,,< ' I

""""*'l',2','tt':"'tj'n aS ' ,4 ;s'r:*""" "" ' "' "' ""'" ' """ """ II

T\ipf OF CRIME (Allincluding M. O. Crirne) : ' II{+srsr no;n (g<,rr.ar q-d q-{fi=itE)' ,

. tt:L--.+tr'fiu t-ieaiJ (ii) -1"'l!rror Hcad : I!/ ;isrr ri,,j 'ilot efr{

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{iii} 'Method (s}: I.r*.€ |t ';)s.""""'&4'(L &?'i't"" II2...."". II3|

(lr) *Convey?:ncer;sedt......"..."..,. ,....q...-......:...' I

qT*dd .;En : zJ /< a4 c "+t'"/- *'\ |

I(v) *Characierassumed:............... I

tffi tqiris I $-.i-dl qdmoft : I

(vi) .Langriagei Slangused: ............... ..........'..... I

sTqT dfr qTsl l"Sr& ?Trw: I

I

ivri) .SpecialFealure"l:"."........"".. l

i'.'lt\q .ii,',.g"i q ,

.Special Feature-2 : .... -.....'.--.fi'-*)q'dp-t*ez-i ,

"Special Feature-3 : ..........fur-{ {RF€-r .

(vlii) .1.ypeof Placeof Occurrence, ....X;.;.{;1.i6\z-- . Dgq-e+ar id+totrq q-*>rq :

'. '.f,-'<usa-{"1

(ix) .TypeoiProperty Involved (4Types) : .....'

'scr*n eTeq-it rflT,

i1)......... . III

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ti\,

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fu'#"\f,ars of the victims (Attach separate sheet, if required) :

qdqr tft*a (erowm cr-*t@rs stie orqq d-ersl) :

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(1)

ii{.,", Name

iIfI

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Faiher's/ Date/Ypar

of BirthSex

tc'trl

l6+i^h^li+, Heligion

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Whethersc/5t

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(.8)

Address

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(10)

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Name

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Motiveof Crime : ..........

x: " 3+:s/

Description of physical evidence from the scene of crime for the property recovered/seized for the purpgse of

investigation :

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il*tuW7. Details of proper

rif {]F$urr$nfg : i*3 ,"2 i't I i y- ]f- "o'uti # ot;s o &

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errrrT-nt* *rzs) frfu,+ €ry*-

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: $ai7

i;ili*tofril,tii;p +r ti;e place of oc$urrenc* (Attach Sketch/Map with legends separately, if needed'

indicate so. iVlay be certified and signed by witnessess, if required :

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Place : ..................i# , at€.(q';<' 'dli;;4

Signature of-ttre l/vestigatton Officer with

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{Saturday {0 to 5 p.rvr.}Sundav Gloseri

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