Before the Hon’ble District/State Consumer Dispute
Redressal Forum at…………
1.
Particulars of
Complainant: ( Full Name &
address)
2.
Particulars of the
Opposite party/Respondent: ( full name of dealer/shop and address)
3.
Particulars of the
defective goods of deficient services complained of:
(a)
Details of
goods/services:
(b)
Describe there the
nature of the complaint: Whether the complaint relates to :
(c)
Any other details
relevant to the complaint ( such as first time when defects in
Goods or deficiency in services was noticed,
steps taken to notify the Opposite Party of the defect /deficiency)
4.
Give details and
nature of attempts made to get the matter complained of settled and result
thereof:
i)
Reminder and follow
up with specific individuals of the Respondent shop/dealer
ii)
Written
communication (attach copies of correspondence)
5.
Other
rules/regulations applicable, if any in this case.
6.
Particulars of
documents relied upon to substantiate the complaint and details of witness
wherever applicable.
7.
Relief claimed:
8.
The forum/ State Commission
has jurisdiction to entertain the complaint in view of:
-
a) Section
11(i)/Section 17 of the Consumer Protection Act
-
b) the extent of
amount involved being Rs……
The
cause of action having accrued at:
PRAYER
It is
therefore most respectfully prayed that ( here give details of prayer)……………………………………………………………………………………………………………………………………………………………………………………………………….Through
Authorized Representative/Advocate/Attorney/Voluntary Consumer Association)
give here names and addresses)
Place…………………… COMPLAINANT
Date…………………….
VERIFICATION
I, ……………………..S/o……………………resident of……………………………do
solemnly declare and state that the particulars stated above are true to the
best of my knowledge and belief and no part thereof is false and nothing
material has been concealed therefrom. The annexure are exact
copies/translation o their originals.
Verified
at ………….this…………day…………..of……….2012.
DEPONENT
No comments:
Post a Comment