Summons on Information of a Probable Breach of the Peace

[See Section 113 of the Criminal Procedure Code]

To ..............of............

WHEREAS it has been made to appear to me by credible information that (state the substance of the information), and that you are likely to commit a breach of the peace (or by which act a breach of the peace will probably be occasioned), you are hereby required to attend in person (or by a duly authorised agent) at the office of the Magistrate of on the day of 19, at ten o'clock in the forenoon, to show cause why you should not be required to enter into a bond for rupees [when sureties are required, add, and also to give security by the bond of one (or two, as the case may be) surety (or sureties) in the sum of rupees (each if more than one)], that you will keep the peace for the term of

Dated, this ..........day of.........19.

(Seal of the Court)

(Signature)