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l,r FORM COMP AA

' (See Rules 253 (c)l 25a @) (iii)l 254 (80255-(1Xiv))c,ED^D'r N A^I IT TI-Itr I/INTAR \/trHICI FS ACCIDENTSc)ED^D-r n ar\l rT Tt-|tr [/lnTAR HICI FS

ffiq €prT {E{q-{ nPqt vra{.? Name of the Police Station

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€ sr frs q Ra,,/t/R. '{ /\/\( ? qt tq q-ilaT

1 Date Time and Place of the accident ls-fl T'TT l9To.qfl-{ q"-qR {s+r illlS(.R.u t?t\t i rt tq qqtn

ffisr1RzrTgftsdtqrqrtrq; srTA-q-s-d d.-a c. so t+rfr ilT5{.

'd Name of thb lnjured / Deceased

Name of Hospital to which he/'she wasremoved

en?ffiI eTe{lad WT-d 4. Ro3 lf,ftTl qlch '1qiq-l_:-ils.

.i

d^qcr qr e^rtr o qqq-q-iq-fiqg-\eR3q qrf,f,f. Number'of veHicles and tYPe of the

, vehicle.to ttame and address of the Driver of the

vehicle with particulars or Driving License

of the said Driver and the address of the

lssuing Authority of the said DrivingLicense. The number of Badge in case ofPublic Service Vehicle and the address of+L^ r<:Ql llNlr/l Ar rfhnriirr nf fha qaid Rar'loe

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ffida{ RR F-rFrRqffi ts ilrET

( Name and address of the Owner of the

vehicle as rt stands on the date of theannidont

ffi qqqq q-flq E"gr=H F.qfi fid1-5c, 'Name and address of the Insurance

Company with whom the vehicle was

insured and the Divisional officer of thesaid Insurance ComPanY.

ffioer of Insurance Policy / Insurance

Certificate and the Date of Validity of the

insurancb )Policyr/ Insurance Certificate

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NHTotVo',"Nandanvan Police

StationNagpur citv-

N.C.R.B .S.eTR.dl.l.F..l ( -r)

FIRST INFORMATION REPORT(Under section 151 qr-.P.C.)

sm {t{j{r RIctC(sKI 154 Te sffir sfgat b a-t-al

1. Distrlct (ff6r):{Frgl {r6q

FrR No. tc.qR. €.): oOoe

2. . 5:!6: {fr'€.}lAcii tn'faFiqsl

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3. (al Occurrence of offence (erqsq ff Erci-qr):

1. Day (fdr):gsEF

Time Perlod (ffiq ffifa):q6{ 4

(h) Addressr(qfrr):

i2(l) OccuPation (i{dffirq}r

Date From tft-{i6 * }: 04/01/2018

Tlme From lvwt 1:12:OOas

......-. ......-...--- -..--i

Date To 1 F<io a-o ):04/01/2018

Time To (q{q ir6'}:12:00 {s

Time (s{q):12:15 ed

B€at No. (ficqi'):

cFrgq {l-8

P.S. (e{Frr}:{*rfi

Date and Tlme of FIR (c.rl(ft' ffftqio rrt{

Year (q.l): 2018

O4IOUZ:ALB 21:42 qd

(i) tnformation received at P's- (e|rII wei qaw rruoate tf?{if }: o4l07l2ol8'q . !.4|r9 \\l i:.)

Dat€ & Time (trci6 qk 11q{ d,rctnoLl 21:35 frst"t c"rr"."t Diary Reference ($s{rssl lnlry No' {qftft o29

4. Type of Information (IFFft iFI n?fic): Oral

5i Plice of Occu!'rence' (qdt{Kercf}::

1. (a) Diraction and distdnce fritm P's'(e[itl $ qe ft f<en Ed' 3 ft{' (b) Address (trdlld{qI fi1'ffii q+t tsfi 'ilI$

complalnaet / |nformant (ftrQr{li(rdf/W1q-df )I

(a) Name (qrq): cl.tar$ffi?r66flt^,-. f atttet's/Uusband's NttglTdtrd /r"' sd oI Ttq.) :

t.f irJtLivlJ'' of Birth 1u'r faft I sq ):rgso

(d*-UtDNo',{tenf,$ €"):'(f) Passport No.(qmqld

Place of, lssue (qrfi 4-{i 6't:Terl{ }:

fgl ii Oetails (Ration card,voter tD card'Passport'uiD No"Driving'": itmc"*;i iio tvpe"(c-€ qt'6ii i--------:-*J{Ig

I mftisf thls'Pdllce'5"i. tisn, tten (gR

'{|Tr Sqr p 1g€ dt:

(s) l.n case,' outside the lir-nltigf tlrts Pollc€')'EaEren' "'-', 'it*r,".fStaiet ifgsr

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rir"eqot*srqft.dEor{,'

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MH-31-CQ-7296q{r a{G.

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8.Reasonsfordelayinreportingbythecomp|ainantlinforma"tt

frqf*'n 3il*crff EfiF4-sd tei gq-qx W 3rgE R-d-er qqtorrrs-{9. Particulars of properties of interest (dsfud wFcR 6I A-fiqrt:

lo. Totat value of pro*11. Inquest Report / U.D. case No., tf any tIFg s*sr R*€ / {"S"n-oTur ri., qR otg d t:

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12. First Information contents {VW q6ar qgq 1,

i5E €r6il dl' ad q ftmroft a|*d ff;qfd eqiqr s-d'tT cBHE qq gggls_gg\ST! Tq 97 9{ giiT iqi* *gs ils m. MH-31-BH-1709 iIPf' gyd ry ume ry qtn+ rqd-dFada 'rlqH ffi-a aqT*i"qTmgr mraa<rrqrs tr_co ion vgc,)ar. erd frqfd}nqFrat,ssafi EKIIFIr s qrqrff ,3reK qlt stsr qnrdr #q"{ q {W R-er ste'nr qft errei.er+ dffi-Eittr#$| ffi g, .t3MAt ikfide qqrqr+s=i s{rET g.dr dE it-dl. '

13' Action taken: since the above Information reveats .commission of offence(s) uls dg mentiohed at, ltem No. 2,(fr Td olffi : {fu wr0m qffinr$ t qr$ Tirfrr t fu srwre oEi or <ntoi rs d. z d s*s sm b a-sn t | )(1) Registered the case and took up theinvestigation: (now {d ft'qprqi orti qfq +

(2) Directed (Name of l.o.) (qiE 3trfEffi .Dr;fiq)! Rupali Devaji Bavankar Rank (qq): st (sub-tnspector)' No'( tLll pprocpRoBFS2ol to tak€ up the lnvestigation {q* qrq erc+sr{ { d+ * frc fttcr ftqT rrq,y{3} Refused investigetion due to (qiqt

or (b orqur fion f6-qr qI}

(4) Transferred to p.S,(eFr): Dlstrict (fSnD:

on point of jurisdiction (al M*on b a -xor awidRafF.l.R. read over to the complainant / informant,admitted to be core<t

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14, Signature/Thumb lm.presslon of the ggmplainant / informant.(tarowre-o-ol I q.d{rrdf A 6-€Tsrt / sr.t} 6r ft{rt;i}:

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AOt @tnat&a'lHame (;ITsIl: Manik Damodar Nilawade .;Rank(qe): | flnspector)Noi{:fi.): PNMH74725

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3. The Place of Occurrence shown bY :

Fathdr"s/Husband'sName : ...............lrfi{ilzl / tftTlq qlcl :-qTcl

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Address:9iTT :

. O. Crime) :

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