WARRANT OF IMPRISONMENT ON FAILURE TO PAY MAINTENANCE
To the Officer in charge of the Jail at____________.
WHEREAS____________ has been proved before me to be possessed of sufficient means to maintain his wife____________[or his child ____________ or his father or mother ____________, who is by reason of____________ unable to maintain herself (or himself)] and to have neglected (or refused) to do so, and an order has been duly made requiring the said____________to allow to his said wife (or child or father or mother) for maintenance the monthly sum of rupees____________ ; and whereas it has been further proved that the said____________ in wilful disregard to the said order has failed to pay rupees____________, being the amount of the allowance for the month of____________ ;
And thereupon an order was made adjudging him to undergo imprisonment in the said Jail for the period of____________
This is to authorise and require you to receive the said____________ into your custody in the said Jail, together with this warrant, and there carry the said order into execution according to law, returning this warrant with an endorsement certifying the manner of its execution.
Dated,____________ this day____________ of ,20 .
(Seal of the Court)
(Signature)