Another Format Senior Citizen: Versus

Another format Senior Citizen
APPENDIX 2
FORMAT – APPLICATION OF SENIOR CITIZEN UNDER
SECTION 5 OF THE MAINTENACNE AND WELFARE OF
PARENTS AND SENIOR CITIZENS ACT, 2007
BEFORE THE HON. TRIBUNAL CONSTITUTED

UNDER THE MAINTENANCE AND WELFARE OF
PARENTS AND SENIOR CITIZENS ACT, 2007
OR
BEFORE THE HON. CHIEF/ADDL. CHIEF/
METROPOLITAN MAGISTRATE, ________COURT,
AT_________, _____________
Application No. of 20__
1. Mr. _____________, Aged -______Yrs )
2. Mrs.____________, Aged -______Yrs )
(Name and Residential Address of the )
Applicant/Senior Citizen) )
______________________ )…Applicant/Senior
Citizen Versus
1. Mr.__________, Aged __Yrs )
(Name of Opponent/daughter/ son) )… Respondents
HUMBLE APPLICATION OF PARENTS UNDER SECTION 5 OF

THE MAINTENANCE AND WELFARE OF PARENTS AND
SENIOR CITIZENS ACT, 2007PRAYING FOR ORDERS/
RELIEFS SECTION 9;
Jurisdiction - Police Station
Most Respectfully Showeth:-
We, the abovenamed Applicant/ Senior Citizen most respectfully

state and submit as follows:
1. That, I a Senior Citizen, aged about ________ years (should be
above 60 yrs) and Guardian of the Respondent. I am presently
staying at one of my relative/friend’s house, having residential
address as _______________ & Contact Nos._________.
2. That, Respondent No. 1 is my adopted son or unrelated person
but known to me, since the year _____________. He is presently
aged _______________ and staying with his wife and children at my
ancestral house/acquired house, having residential address as
_______________ & Contact Nos. - _________.
3. That, the facts and circumstances of our grievances are as

follows:-
(a) That I am a ‘Bachelor or Sprinter’ or I had married Mrs. Or
Mr._________ on but on___________, my wife expired and there

was no issue from the marriage. Since, the said date of death of
my wife/husband, I was surviving alone in this world till
___________ and on______________, I came in contact with the
Respondent, who then, was a young man working in Firm/
Company near to my residence. Our contact developed cordially,
I decided to adopt him as my son and I adopted him as my son
on _________ and allowed to stay with me at my
house______________.
(b) That , thereafter, I looked after the welfare of the Respondent, as I

was fond of him and treated him as my own ‘son’ and

subsequently, I arranged for his marriage and got him married to
a girl by name __________ of his own choice and allowed his wife
also to join under-section . Gradually, the Respondent was
blessed with two all children named __________ and presently
they are aged ________________. (Give further details)
…………………. (Annexed herewith and marked paid to my said
Adopted son for his personal use and marriage expenses).
(c) That, on ____________, I transferred my said immovable property i.

e. ancestral property/acquired property i.e. (Give the details of

the immovable properties) on the name of said adopted son,
through ‘Gift-Deed’, confidently thinking that the Respondent will
look after me as usually, he did till the said date i.e.____________
(Annexed herewith and marked as Exhibit - ___________is a copy
of the said Gift-Deed dated _____________).
(d) That, but since_________- (Give the events and incidents in

chronological order)…………the Respondent started ignoring me,

insulting me and found out opportunities to scold me and drive
me out of my own house…………………
(e) That, finally, on ______________, I was thrown out of my said
house and since then, I am staying at_______________ and…………

(Give other concerned details).
(f) That, I am suffering from ______________since _______ and

attention and treatment but the Respondent and his wife is
ignoring ………………..(Give further concerned details).
(g) That, …………………………………………….
4. That, my said adopted son/Son/Daughter is employed with
_____________ as “________________” and earning a monthly
income of Rs._____________/- OR carrying out business in the
name and style of “_______________” and earning a total monthly
income of Rs._____________/-. ._____________/-. In addition, I
have transferred my aforesaid immovable properties on his name
as such; it is his bounden and mandatory duty, to look after my
basic necessities of life.
5. Under the aforesaid facts and circumstances, I pray that this
honourable Court may be pleased:
(a) To grant Rs. 10,000/- as Maintenance which includes food,
clothing, residence and medical attendance and treatment in our
favour.
(b) To order for such further and other relief orders and directives as
the nature and circumstances of the case may require or justify

or as the Honourable Court may deem fit and proper in the
aforesaid facts and circumstances of the case;
And for this act of kindness, I shall ever pray for.
Dated this _______ day of _______, 20__, at________.
Applicant
APPLICANT DRAFTED, EXPLAINED

AND INTERPRETED BY:
Advocate/s for the Applicant

(Office Address & Telephone No. of the Advocate/s)
Rohit Kishan Naagpal
Advocate , Supreme Court of India
X-8,Eastern Wing (Civil Side),
Lawyers Chamber,
Tis Hazari Courts , Delhi-54
LIST OF DOCUMENTS
1. Ex-A – Copy of ____________________________. –
2. Ex-B – Copy of ____________________________. –
3. Ex-C – Copy of ____________________________. –
4. Ex-D – Copy of ____________________________. –
5. Ex-E – Copy of ____________________________. –
6. Any other documents with the permission of this honourable
Court.
Applicant
____________________________
Rohit Kishan Naagpal
Advocate , Supreme Court of India
X-8,Eastern Wing (Civil Side),
Lawyers Chamber,
Tis Hazari Courts , Delhi-54
Advocate/s for the Applicant

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Another format Senior Citizen

BEFORE THE HON. TRIBUNAL CONSTITUTED

HUMBLE APPLICATION OF PARENTS UNDER SECTION 5 OF

Jurisdiction - Police Station

Most Respectfully Showeth:-

We, the abovenamed Applicant/ Senior Citizen most respectfully

3. That, the facts and circumstances of our grievances are as

Mr._________ on but on___________, my wife expired and there

(b) That , thereafter, I looked after the welfare of the Respondent, as I

was fond of him and treated him as my own ‘son’ and

(c) That, on ____________, I transferred my said immovable property i.

e. ancestral property/acquired property i.e. (Give the details of

(d) That, but since_________- (Give the events and incidents in

chronological order)…………the Respondent started ignoring me,

house and since then, I am staying at_______________ and…………

(f) That, I am suffering from ______________since _______ and

the nature and circumstances of the case may require or justify

APPLICANT DRAFTED, EXPLAINED

Advocate/s for the Applicant

Advocate/s for the Applicant

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Mr._ on but on___, my wife expired and there

(f) That, I am suffering from ________since _ and