BEFORE THE HONBLE NATIONAL / STATE / DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION/FORUM AT ( CITY ).

COMPLAINT UNDER CONSUMER PROTECTION ACT, 1986. IN THE MATTER OF : (Name and address of complainant) .................... COMPLAINANT VERSUS (Name and address of the accused) .................... OPPOSITE PARTY INTRODUCTION: A brief paragraph about the complainant explaining the name, residence address and occupation of the complainant. A brief paragraph about name, address and occupation of the opposite party.

RESPECTFULLY SHOWETH: 1. Description of the deal and services promised by the opposite parties for the value paid by the complainant. . Description of the advertisements given by the opposite parties !hich attracted the complainant to purchase the commodity and services.

TRANSACTION : Details of the price of goods and services. Details of the bill"invoice (bill number and date, item and amount) Details of payments made by complainant (che#ue number"cash, etc.)

NATURE OF COMPLAINT: (select from list or write as required) 1. $isleading advertisements and false representation. . %heating by giving false promises. &. Deficiency in after sales service or not abiding by !arranty clause. '. (arassment by the opposite party. ). Not delivering the goods and services for !hich payment is made. *. %harging excess amount. +. Any other factors that affected the consumer.

OTHER EVIDENCES OF SUPPORT OF COMPLAINT:

%opy of advertisement and catalogue that promised the concerned goods and services. %opy of bill as evidence of purchase. ,ther documents such as agreement copies, bounced che#ues, opposite parties- letters. %opy of letters sent to the opposite party to re#uest for rectification of fault and settlement of the grievance.

JURISDICTION: (Select one) As the total amount involved is more than .upees 1 crore, the complaint is being filed !ith the (on-ble National %onsumer Disputes .edressal %ommission. OR As the total amount involved is more than .upees / la0hs and less than 1 crore, the complaint is being filed !ith the (on-ble 1tate %onsumer Disputes .edressal %ommission. OR As the total amount involved is less than .upees / la0hs, the complaint is being filed !ith the (on-ble District %onsumer Disputes .edressal 2orum.

PRAYER: The complainant therefore prays :i) relief be granted to the complainant as demanded herein. ii) that such orders be passed as the (on-ble %onsumer 2orum may deem fit in the circumstances of the case. iii) that the accused should be punished severely so that culprits of similar 0ind !ould be afraid to indulge in such criminal activities. iv) mention any other statement of prayer you !ish to state. PLACE : DATED : 1ignature NAME OF THE COMPLAINANT

VERIFICATION I (nam !" #!m$%a&nan')( ) *&+ n' !" () *&+ n'&a% a++) **) , ) -. + #%a) ',a' I ,a/ n!' m&*) $) * n' + an. "a#'* n!) ,a/ ')& + '! ,&+ an. &n"!)ma'&!n &n m. a-!/ #!m$%a&n'. A%% ', "a#'* m n'&!n + , ) &n a) ')0 '! ', - *' !" m. 1n!2% +3 . Nam 4 *&3na'0) !" ', #!m$%a&nan' P% a* n!' : The affidavit should be notarized before further copies of complaint set are made for submission. A))an3 m n' !" ', #!m$%a&n' $a$ )*: All papers to be 0ept in paper file in follo!ing order: 1. %omplaint

. Affidavit &. 3ist of documents '. Documents ). 4a0alatnama *. Application for in5unction (if any) +. Application for condonation of delay (if any) 6age numbers to be !ritten on lo!er right corner. Deposit the complaint file at the consumer court along !ith appropriate court fee.