Tamilnadu Prohibition of Child Marriage Rules, 2009

Form I

(See rule -3)

Child Marriage Incident Report

1. Details of the complainant / Party to the child marriage:

(1) Name of the complainant / Party to the child marriage:

(2) Age:

(3) Present Address:

(4) Phone Number,If any:

2. Details of respondents:

Sl. No.	Name	Address	Tel. No.

3. Details of Marriage:

Sl. No.	Date, Place and Time of Child Marriage	Performer

4. List of documents attached:

Name of document	D
Birth Certificate
Doctor's Certificate for age verification
List of money, Ornaments, valuables, gifts given at the time of marriage

5. Order that need to be obtained under the Prohibition of Child Marriage Act, 2006 (Central Act 6 of 2007):

Sl. No.	Orders	Yes / No
1.	Prohibitory injunction under Section 13.
2.	Annulment order under Section 3.
3.	Residence order under Section 4(4).
4.	Maintenance order under Section 4(1).
5.	Custody order under Section 5.
6.	Restriction order under Section 3(4).
7.	Any other Order.

6. Assistance needed:

Sl. No.	Assistance available	Yes / No
1.	Counsellor
2.	Police Assistance
3.	Assistance for initiating Criminal Proceedings
4.	Shelter home
5.	Medical Facilities
6.	Legal Aid

Place ...........	...................................... (Counter signature of Prt)
Date .............	Name.....................
	Address..................

P. RAMA MOHANA RAO,
Principal Secretary to Government

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