Page 722 - The Central Motor Vehicles Rules, 1989

694 THE CENTRAL MOTOR VEHICLES RULES, 1989 ANNEXURE-XIII

FORM-VIA
VICTIM’S FORM RELATING TO MINOR CHILDREN OF VICTIM(S)
By Victim(s) to Investigating Officer within sixty (60) days of Accident
Copy to Child Welfare Committee and SLSA
FIR No.
Date
Under Section
Police Station

Details of the Minor Children (18 years or below)
S. No. Details of Children Child 1 Child 2 Child 3 Child 4
1. Name

2. Age/Date of Birth
3. Sex
4. SC/ST/OBC/General
5. Father’s Name
6. Mother’s Name
7. Guardian’s Name
(If different from parent)
8. Family Income (Annual)
9. Permanent Address
10. Present Address
11. Contact No. of father/mother/family
member
12. Whether the child is differently abled:
If yes, give details

13. Present living conditions/economic
condition (after the accident)
Educational details of children
14. Current status of education
Level of education (class)

Whether the child is enrolled under
EWS quota
15. If not attending school, reasons to be
provided

16. Detailed information of the school where the child is studying