G. O. (P) No. 21/2007/SWD Dated Thiruvananthapuram,30th April, 2007
S.R.O No. 408/2007 - In exercise of the powers conferred bysub section (1) of the Protection of Women from Domestic ViolenceAct, 2005 (Central Act 43 of 2005) and in supersession of thenotification issued in G.O. (P) NO. 04/2007/SWD dated 2nd January2007 and published as S.R.O. No. 80/07 in the Kerala GazetteExtraordinary No. 135 dated 23rd January 2007, Government of Keralahereby appoint the following officers as Protection Officer to exercisethe powers and perform duties conferred on him/her by or under thesaid Act in the area of their jurisdiction.
NAME AND ADDRESS OF DISTRICT PROBATION OFFICER
Sl. Probation Officer’s Address JurisdictionNo. Headquarters(1) (2) (3) (4)
1. Thiruvananthapuram Dist. Probation Officer Grade I, Thiruvananthapuram TalukDist. Probation Office, (Except Corporation Area)Poojappura, Tvpm. and Neyyattinkara Taluk
i\n 1929 `m{Zw 10GOVERNMENT OF KERALASocial Welfare (B) Department
NOTIFICATIONS
G. O. (P) No. 46/2007/SWD Dated Thiruvananthapuram,21st August, 2007
S.R.O No. 731/2007 - In exercise of the powers conferred bysection 10 (1) of the Protection of Women from Domestic ViolenceAct, 2005 (Central Act 43 of 2005) Government herebynotify the following institutions as ‘Service Providers ’ for the purposeof the Act, namely:-
1. HELP LINE CENTRES
Sl. Name & Address of the LocationNo. Institution
1. The Dale View, Punalal P.O, The Dale View, Punanal P.O,Poovachal, Poovachal,Thiruvananthapuram. Thiruvananthapuram.
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Sl. Name & Address of the LocationNo. Institution
2. Kerala Association for Social and Thalassery, KannurWomen’s Welfare,Mupparayil Building,Vellayittambalam, Kollam
3. Sreeeniketan Centre for Social Chathannoor, KollamDevelopment, Chathannoor P.O,Kollam
4. International Centre for Study and ICSD, Shangarilla HillsDevelopment (ICSD) Valakom, KollamShangarilla Hills, Valakom, Kollam
5. Jawaharlal Memorial Social Thalayolaparambu,Welfare Public Co-operation Centre KottayamThalayolaparambu. P.O.,Kottayam
6. Voluntary Organisation for Social VOSARDAction and Rural Development Kumily, Idukki(VOSARD), KumilyIdukki - 685 509
7. Solidarity Movement of India, HelplineCentral Committee, Idukki Adimali,Kanjikuzhy P.O, Idukki Idukki
8. People’s Service Society Peoples Service SocietyDiocesan Pastoral Centre, Opp. KSRTC Bus Stand,Palakkad Palakkad.
9. Mirror Centre for Social Change, Sulthan BatheryBeenachi P.O, Dottappankulam, WayanadSulthan Bathery,Wayanad - 673 592
G. O. (P) No. 86/2007/SWD Dated Thiruvananthapuram,30th November, 2007
S.R.O No. 1052/2007. - In exercise of the powers conferred byclause (j) of section 2 and section 7 of the Protection of Women fromDomestic Violence Act, 2005 (Central Act 43 of 2005) the Governmentof Kerala hereby notify all the District/Taluk Hospitals of the State tobe the Institution for providing medical facility for the purpose of thesaid Act and the Resident Medical Officer of the said Hospital to be theofficer in charge of the medical facility to provided medical adi to theaggrieved person.
By order of the Governor,
LIDA JACOB
Secretary to Government
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Explanatory Note
(This does not form part of the notification, but is intended toindicate its general purport.)
As per clause(j) of section 2 of the Protection of Women fromDomestic Violence Act, 2005 (Central Act 43 of 2005) ths StateGovernment may notify such facility to be a medical facility for thepurposes of the said Act. Therefore, the Government have decided todeclare all the District/Taluk Hospitals of the State as Institution forproviding medical facility for the purposes of the Act and ResidentMedical Officer of the said Hospital to be the officer in charge of themedical facility to provide medical aid to the aggrieved person,
This notification is intended to achieve the above object.
12. Jawaharlal Memorial Social FCC, Palamkadan Road,Welfare Public Co-operation Kottayam,Centre, Thalayolaparam1bu P.OKottayam - 686605
Idukki
13. Sopanam Family Sopanam FCCCounselling Centre Adimali, IdukkiAdimali, Adimali P.O.,Idukki
14. Peermade Development Society FCC, Near St George ChurchP.B, No 11, Peermade, Kattappana,Idukki (District) IdukkiPin - 685 531
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Sl. Name & Address of the LocationNo. Institution
1 2 315. Voluntary Organisation for VOSARD, Kumily
Social Action & Idukki.Rural Development (VOSARD)Kumily P.O.,Idukki, Pin- 685 531
16. Solidarity Movement of India Kanjikuzhi, IdukkiCentral Committee, IdukkiKanjikuzhi, Idukki.
Ernakulam
17. St.Jude Home Science Institute St. Jude Home ScienceKarukutty P.O., Institute,Ernakulam, Pin 683576 Ernakulam
18. Legal Industrial & Socio LISS India, Opp St. GeorgeEducational Society of India, High School,Opp. Vimalagiri Public School, KothamangalamKothamangalam P.O., Ernakulam - 686 691Ernakulam - 686691
19. Peoples Council for Valanjambalam,Social Justice (PCSK) ErnakulamAppu Soudham,Ravipuram Road,Valanjambalam,Kochi - 682 016
G. O. (P) NO. 19/2008/SWD. Dated Thiruvananthapuram,29th January, 2008
S.R.O No. 276/2008 - In exercise of the powers conferred byclause (t) of secton 2 of the Protection of Women from DomesticViolence Act, 2005 (Central Act 43 of 2005) and in supersession of thenotification issued in G.O.(P) No. 45/2007/SWD, dated 21st August,2007 and published as S.R.O. No. 730/2007 in the Kerala GazetteExtraordinary No. 1602 dated 1st September, 2007, Governemnt ofKerala hereby notify the following instituions as ‘Shelter Homes’ forthe purpose of the Act, namely:-
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Sl. No. Name & Address of the Institution Location
2. Association for Social Health Short Stay Home,in India Association of SocialKesavapuram Road, Health in India,Poojappura, Kesavapuram Road,Thiruvananthapuram Poojappura,
(This does not form part of the notification, but is intended toindicate its general purport.)
Clause (t) of Section 2 of the Protection of Women fromDomestic Violence Act, 2005 (Central Act 43 of 2005) provides fornotification of ‘Shelter Homes’ for the purposes of the Act, Governmenthave decided to notify the institutions mentioned above as ‘ShelterHomes’ for giving protection to the Women affected by domesticviolence.
This notification is intended to achieve the above object.
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A\p-_‘w VIFORM - I
[See Rule 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:
S. No. Name Relationship with the Address Telephone No.aggrieved person 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 atpresent residing
3. Incidents of domestic violence :S. No. Date, Place and Person who Type of Violence Remarks
time of Violence causeddomestc Physical Violenceviolence
Causing hurt of anykind, please specify
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(i) Sexual ViolencePlease tick mark [ ] the column applicable
Forced sexual intercourseForced to watch pornographyor other obscene materialForcibly using you aEntertain othersAny other act of sexualnature, abusing, humiliating,degrading or otherwisevilative of your dignity(Please specify details in thespace provided below) :
(ii) Verbal and emotional abuseAccusation/aspersion onyour character or conduct,etc.Insult for not bringingdowry etc.Insult for not havinga male childInsult for not havingany child.Demeaning, humiliating orunderminning remarks/statement.RidiculeName callingForcing you to not attendschool, college or any otherEducational institution.Preventing you from takingup a jobPreventing you from leavingthe Houses
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Preventing you from meetingany Particular person.Forcing you to get marriedagainst your will.Preventing you frommarrying a person of yourchoice.Forcing you to marry aperson of his/their ownchoice.Any other verbal oremotional abuse.(Please specify in the spaceprovided below).
(iii) Economic ViolenceNot providing money formaintaining you or yourchildrenNot providing food, clothes,Medicine, etc., for you oryour childrenForcing you out of the houseyou live in.Preventing you fromaccessing or using any partof the housePreventing or obstructing youfrom carring on youremploymentNot allowing you to takeup an employmentNon-payment of rent in caseof a rented accomodation.Not allowing you to useclothes or articles of generalhousehold use.
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Selling or pawing yourstridhan or any othervaluables without informingyou and without your consent.Forcibly taking away yoursalary, income or wages etc.Disposing your stridhanNon-payment of other billssuch as electricity etc.Any other economic violence(Please specify in the spaceprovided below)
(iv) Dowry related harassmentDemands for dowry made,Please specifyAny other detail with regardto dowry, please specify,Whether details of dowryitems, stridhan, etc. attachedwith the form.YesNo
(v). any other information regarding acts of domestic violenceagainst you or your children
(Signature of thumb impression of the complainant/aggrieved person)
5. List of documents attachedName of Document Date Any other detailsMedico legal certificateDoctor’s certificate ofany other prescriptionList of StridhanAny other document
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6. Order that you need under the Protection of Womenfrom Domestic Violence Act. 2005
S.No. Orders Yes/No. Any other1. Protection order under section 182. Residence order under section 193. Maintenance order under section 204. Custody over under section 205. Compensation order under section 226. Any other order (specify)
7. Assistance that you needS.No. Assistance available Yes/No. Nature of
assistance(1) (2) (3) (4)1. Counsellor2. Police Assistance3. Assistance for initiating
criminal proceedings4. Shelter home5. Medical facilities6. Legal aid
8. Instructions for the Police Officer assisting in registration of aDomestic Incident Report :
Wherever the information provided in the Form discloses anoffence under the Indian Penal Code or any other law, the police officershall -
(a) inform the aggrieved person that she can also initiate criminalproceedings by lodging a First Information Report under the Codeof Criminal Proceedure, 1973 (2 of 1974)
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(b) if the aggrieved person does not want to initiate criminalproceedings, then make daily dairy entry as per the informationcontained in the domestic incident report with a remark that theaggrieved person due to the intimate nature of the relationship withthe accused wants to pursue the civil remedies for protection againstdomestic violence and has requested that on the basis of theinformation received by her, the matter has been kept pending forappropriate 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 personmedically 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.
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FORM - II
[See Rule 6(1)]
Application to the Magistrate under Section 12 of the Protectionof Women from Domestic Violence Act, 2005 (43 of 2005)
To
The Court of Magistrate
........................................
........................................
........................................
Application under section........of theprotection of Women from Domestic
Violence Act, 2005 (43 of 2005)
Showeth:
1. That the application under section.....of protection ofwomen from Domestic Violence Act, 2005 is being filed alongwith acopy of Domestic Incident Report by the:-
(a) Aggrieved person(b) Protection Officer(c) Any other person on behalf
of the aggrieved person(tick whichever is applicable)
2. It is prayed that the Hon’ble court may take cognizanceof the complaint/Domestic Incident Report and pass all/any of theorders, as deemed necessary in the circumstances of the case.
(a) Pass protection order under section 18 and/or(b) Pass residence order under section 19 and/or(c) Direct the respondent to pay monetary relief under
section 20 and /or(d) Pass orders under section 21 of the Act and/or
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(e) Direct the respondent to grant compensation or damagesunder section 22 and/or
(f) Pass such interim orders as the court deem just andproper.
(g) Pass any orders as deems fit in the circumstances of thecase.
3. Orders required(i) Protection Order under section 18
Prohibiting acts of domestic violence by granting aninjunction against the Respondents from repeating anyof the acts mentioned in terms of column 4(a)/(b)/(c)/(d)/(e)/(f)/(g) of the application.
