Domestic Violence Legal Format

Application under Section 12 of the Protection of Women from Domestic Violence Act, 2005

Updated sample application to the Magistrate based on Section 12 of the Protection of Women from Domestic Violence Act, 2005 and Form II prescribed by Rule 6(1) of the Protection of Women from Domestic Violence Rules, 2006.

Key legal point: Section 12 allows an aggrieved person, a Protection Officer, or any other person acting on her behalf to seek one or more reliefs under the Act. Rule 6(1) provides that an application made by the aggrieved person should be in Form II or as nearly as possible thereto.

Section 12: Application to the Magistrate

Section 12 is the principal provision for approaching the Magistrate for relief under the Domestic Violence Act. Before passing an order on the application, the Magistrate must take into consideration any Domestic Incident Report received from the Protection Officer or a service provider.

The relief sought may include compensation or damages, without prejudice to the aggrieved person's right to pursue an appropriate civil claim. The application must be in the prescribed form or as nearly as possible to it.

The first date of hearing should ordinarily be fixed within three days from receipt of the application by the court. The Magistrate is required to endeavour to dispose of the application within sixty days from the first hearing.

Who can present a Section 12 application?

The application may be presented by:

  • the aggrieved person;
  • a Protection Officer; or
  • any other person on behalf of the aggrieved person.

An "aggrieved person" is a woman who is, or has been, in a domestic relationship with the respondent and alleges that she has been subjected to an act of domestic violence. The statutory concept of a domestic relationship is not confined to marriage and may include relationships arising from consanguinity, marriage, a relationship in the nature of marriage, adoption, or family members living together as a joint family, subject to the facts and applicable law.

Reliefs that may be requested

Section 18Protection orders against acts or threatened acts of domestic violence and specified conduct.
Section 19Residence orders concerning the shared household or alternate accommodation, where legally appropriate.
Section 20Monetary relief for expenses and losses arising from domestic violence, including maintenance where applicable.
Section 21Temporary custody of a child or children and appropriate visitation directions.
Section 22Compensation and damages for injuries, including mental torture and emotional distress.
Section 23Interim orders and, where the statutory conditions are satisfied, ex parte relief.

Section 17 separately recognizes the right of a woman in a domestic relationship to reside in the shared household, whether or not she has any right, title or beneficial interest in it, subject to the statutory framework and orders of the competent court.

Where can the application be filed?

Jurisdiction is governed by Section 27 of the Act. Depending on the facts, proceedings may be instituted before the competent Magistrate within the local limits where the aggrieved person permanently or temporarily resides, carries on business or is employed; where the respondent resides, carries on business or is employed; or where the cause of action has arisen.

Practical point: A temporary place of residence can be relevant under Section 27. The court heading should therefore be adapted to the competent Magistrate and local jurisdiction in the particular State or Union Territory.

Updated Section 12 Domestic Violence Application Format

This general format follows the structure and relief categories of prescribed Form II while allowing space for case-specific pleadings. Delete reliefs that are not applicable and add the necessary facts, dates, addresses and supporting particulars.

IN THE COURT OF THE JUDICIAL / METROPOLITAN MAGISTRATE AT __________

APPLICATION / CASE NO. ______ OF 20__

IN THE MATTER OF:

Ms./Mrs. __________________________AGGRIEVED PERSON / APPLICANT

VERSUS

1. ______________________________RESPONDENT NO. 1
2. ______________________________RESPONDENT NO. 2

Police Station, if relevant: __________________________

APPLICATION UNDER SECTION 12 OF THE PROTECTION OF WOMEN FROM DOMESTIC VIOLENCE ACT, 2005 READ WITH THE PROTECTION OF WOMEN FROM DOMESTIC VIOLENCE RULES, 2006

MOST RESPECTFULLY SHOWETH:

1. Status of applicant. The Applicant is an aggrieved person within the meaning of Section 2(a) of the Act and has been in a domestic relationship with the Respondent(s). The nature of the relationship is: ______________________________.

2. Domestic relationship and shared household. The parties lived together / had the right to live together at ________________________________________. The relevant period and particulars are ________________________________________.

3. Applicant filing the proceeding. This application is presented by:

  • Aggrieved person
  • Protection Officer
  • Another person acting on behalf of the aggrieved person

4. Domestic Incident Report. A Domestic Incident Report dated __________ is annexed / has been prepared by the Protection Officer or service provider / is not presently available. Particulars, if any: ______________________________.

5. Acts of domestic violence. The Applicant has been subjected to acts, conduct and/or omissions constituting domestic violence, including the following, as applicable:

  • Physical abuse or threat of physical abuse
  • Sexual abuse
  • Verbal and emotional abuse
  • Economic abuse or deprivation of financial resources
  • Dowry-related harassment or unlawful demands, where applicable
  • Threats, intimidation, harassment or interference with employment, education or communication
  • Deprivation of stridhan, property, access to the shared household or other economic resources
  • Other conduct: ________________________________________

6. Material incidents. The principal incidents, with dates and places so far as known, are:

(a) On __________ at __________, ________________________________________.

(b) On __________ at __________, ________________________________________.

(c) On __________ at __________, ________________________________________.

7. Children / dependants. The Applicant has the following child/children or dependants relevant to the relief claimed: ________________________________________.

8. Immediate risk or need for interim protection. The circumstances requiring urgent or interim protection, if any, are: ________________________________________.

9. Previous or pending proceedings. Details of any connected matrimonial, maintenance, custody, criminal, civil or other proceedings between the parties are: ________________________________________.

Reliefs claimed

(A) Protection Order under Section 18

  • Restrain the Respondent(s) from committing or aiding any act of domestic violence.
  • Restrain the Respondent(s), where appropriate, from entering the Applicant's workplace, school, educational institution or other place frequented by her.
  • Restrain unwanted personal, oral, written, electronic, telephonic or other communication.
  • Restrain alienation of relevant assets or operation of bank lockers/accounts to the extent permitted by Section 18.
  • Restrain violence or intimidation against dependants, relatives or persons assisting the Applicant.
  • Other appropriate protection: ______________________________.

(B) Residence Order under Section 19

  • Restrain dispossession or exclusion of the Applicant from the shared household except by procedure established by law.
  • Restrain interference with the Applicant's possession or access to the portion of the shared household in which she resides, where legally appropriate.
  • Restrain alienation, disposal or encumbrance of the shared household as permitted by law.
  • Direct the Respondent to remove himself from the shared household, where the statutory requirements permit such an order.
  • Direct provision of suitable alternate accommodation of the same level or payment of rent, where applicable.
  • Permit access to personal effects, stridhan and belongings, where appropriate.
  • Other residence relief: ______________________________.

(C) Monetary Relief under Section 20

  • Loss of earnings: Rs. __________
  • Medical expenses: Rs. __________
  • Loss caused by destruction, damage or removal of property: Rs. __________
  • Food, clothing, medicine and basic living expenses: Rs. __________ per month
  • Child education and related expenses: Rs. __________ per month
  • Household / accommodation expenses: Rs. __________ per month
  • Maintenance for the Applicant and/or children, where applicable: Rs. __________ per month
  • Other monetary relief: Rs. __________

(D) Temporary Custody under Section 21

Grant temporary custody of the child/children ______________________________ to the Applicant / person acting on her behalf and pass suitable visitation directions consistent with the welfare and safety of the child/children.

(E) Compensation under Section 22

Direct the Respondent(s) to pay compensation and damages of Rs. __________ or such amount as the Court considers appropriate for injuries, mental torture, emotional distress and other harm caused by the acts of domestic violence.

(F) Interim / Ex Parte Relief under Section 23

Pending final disposal, grant such interim protection, residence, monetary, custody or compensation-related relief as is legally permissible. Where ex parte relief is sought under Section 23(2), the Applicant relies upon the prescribed supporting affidavit.

PRAYER

In the above facts and circumstances, the Applicant most respectfully prays that this Hon'ble Court may be pleased to:

(a) grant the reliefs specifically claimed above under Sections 18, 19, 20, 21, 22 and/or 23 of the Protection of Women from Domestic Violence Act, 2005, as applicable;

(b) pass such interim or protective directions as may be necessary for the safety and protection of the Applicant and any child/dependant concerned;

(c) grant such other or further relief as this Hon'ble Court may deem just, lawful and proper in the facts of the case.

PLACE: __________
DATE: __________

AGGRIEVED PERSON / APPLICANT
Through Counsel, if represented
____________________________

VERIFICATION

I, __________________________, the Applicant above named, verify that the contents of paragraphs ____ to ____ are true and correct to my knowledge, those based on records are believed to be true, and nothing material has been concealed.

Verified at: __________ on __________.

APPLICANT / DEPONENT

For an ex parte order: Section 23(2) allows an ex parte order where the Magistrate is satisfied on a prima facie basis that domestic violence has occurred, is occurring, or is likely. Rule 6(4) prescribes Form III for the supporting affidavit. The exact affidavit and relief must be tailored to the facts.
Download Section 12 Application in MS Word

Documents commonly used with a Section 12 application

The documents depend on the facts. A marriage certificate is not universally mandatory because the Act is not limited to legally married women. Relevant material may include:

  • identity and address material of the Applicant, where required by local filing practice;
  • Domestic Incident Report, if prepared or available;
  • supporting affidavit, including Form III where ex parte relief under Section 23(2) is sought;
  • medical records, photographs, messages, emails or other material relied upon to establish the alleged incidents;
  • police complaints, FIRs or representations, if any;
  • documents concerning the shared household, rent, accommodation or household expenditure, where residence relief is sought;
  • income, bank, salary, expense and liability documents relevant to monetary relief or maintenance;
  • school fees, medical expenses and other child-related documents, where applicable;
  • orders or pleadings from related matrimonial, maintenance, custody, criminal or civil proceedings;
  • documents concerning stridhan, property or economic abuse, where relied upon.

Registry and filing requirements can differ between States, Union Territories and court establishments. The prescribed statutory forms and local court directions should be checked before filing.

Domestic Incident Report is not the same as the Section 12 application

The Domestic Incident Report is prescribed separately in Form I of the 2006 Rules. Section 12 requires the Magistrate to consider any Domestic Incident Report received from the Protection Officer or service provider before passing an order. The statutory text also permits the application itself to be presented by the aggrieved person, a Protection Officer or another person on her behalf.

Procedure and related proceedings

Section 28 contains the procedural framework for proceedings under Sections 12, 18 to 23 and offences under Section 31, subject to the Act and the court's statutory power concerning its own procedure for disposal of applications under Section 12 or Section 23(2). Section 26 further permits relief under Sections 18 to 22 to be sought in other legal proceedings before a civil court, family court or criminal court where the statutory requirements are met.

Because criminal procedure law in India changed with the commencement of the Bharatiya Nagarik Suraksha Sanhita, 2023 on 1 July 2024, current court and Registry practice should be checked where the Act or Rules contain legacy references to the Code of Criminal Procedure, 1973.

Official legal sources

India Code - Domestic Violence Act, 2005 Official Act PDF Domestic Violence Rules, 2006 - Official Gazette PDF

Frequently asked questions

Must the applicant be a legally married wife?

No. The definition of domestic relationship is wider than marriage and can include specified family and relationship categories under the Act. The precise applicability depends on the facts.

Can someone else file on behalf of the aggrieved woman?

Yes. Section 12 expressly allows a Protection Officer or any other person acting on behalf of the aggrieved person to present the application.

Can interim protection be requested immediately?

Yes. Section 23 empowers the Magistrate to pass interim orders. Ex parte relief may also be granted where the statutory conditions in Section 23(2) are satisfied and the prescribed affidavit is filed.

Is a Domestic Incident Report compulsory before a woman approaches the Magistrate?

Section 12 requires the Magistrate to consider a Domestic Incident Report if one has been received. The provision itself nevertheless authorizes the aggrieved person, Protection Officer or another person on her behalf to present the application. Filing practice should be checked in the relevant court.

What reliefs are commonly claimed?

Depending on the case, protection, residence, monetary, temporary custody, compensation and interim or ex parte relief may be sought under Sections 18 to 23.

Disclaimer: This page provides a general legal format and statutory overview. Domestic violence proceedings are fact-sensitive. The final application should accurately state the incidents, relationship, jurisdiction, relief sought and supporting material, and should comply with current local court practice and applicable judicial directions.