Annexure-III
Model Form of Complaint
TITLE
OF COMPLAINTS
IN THE CONSUMER
DISPUTES REDRESSAL COMMISSION AT....................
Consumer
Complaint No..................... of 19....................
A. B. (add
description and residence).............................
Complainant/Complainants
versus
C. D. (add description and residence).....................
Opposite Party/Opposite Parties
To
The Hon’ble President and his companion members of the
State Commission.
Sirs,
The Complainant/Complainants named above respectfully
submits/submit as follows:
1. All facts relating to the complaint, particulars, place,
date etc. are to be stated.
2.
3.
4. Details
regarding cause of action at the place where the complaint is being filed.
5. Details
relating to jurisdiction and value of goods/services and compensation claim are
to be given.
6. Prayer
clause with details of relief/reliefs being claimed are to be stated.
Place....................
Complainant/Complainants
Date....................
In
person or through Counsel
VERIFICATION
I/We.................... (Complainant/Complainants)
son/sons of.................... resident of.................... do hereby
solemnly declare and state that the contents/ particulars of the complaint
stated above are true to the best of knowledge and belief. Nothing stated
therein is false and nothing has been misstated/concealed therein.
Verified at.................... this................. day
of.................... 19....................
Deponent
Annexures
1. ........................
2. ........................
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