Petition by wife for judicial separation on the grounds of her husband's adultery
(See section 22)

                                                     In the High Court of…………………..
                                                                          CB                                 Petitioner
                                                                       Versus
                                                           AB                             Respondent
To the Hon'ble Mr. Justice……….
(or to the Judge of………………..)
The humble petition of CB of No………………..
the wife of AB residing at……………………….
Sheweth:
1. That on the….day of……..your petitioner, then CD (maiden name) was lawfully married to the respondent AB lived and cohabited at ……and…….and the said marriage is still subsisting.
2. That ever since the said marriage, your petitioner and the respondent AB lived and cohabited at……….and they have the following issue living of their said marriage.
3. That on diverse occasions between the month of……… and the month of…….the respondent AB while staying at………..committed adultery with one EF who was then in the service of the said AB and your petitioner at their said residence aforesaid against the wishes of and in spite of protest from your petitioner.
4. That your petitioner has not condoned any of the acts of adultery on the part of the respondent.
5. That there is no collusion or connivance between your ……. petitioner and the said AB with respect to the subject of the present suit. Your petitioner therefore prays that this (Hon'ble) Court might be pleased to pass a decree of a judicial separation of your petitioner from her said husband by reason of his aforesaid act of adultery.
Signed                                                                                     CB

Verification
I, CB wife of AB daughter of XY aged about…………..years residing at do hereby solemnly affirm and say as follows:

State the respective ages of the children.
I am the petitioner above-named and I know and I have made myself acquainted with the facts and circumstances of this case.
The statements made in paragraphs 1 to 5 are true to my knowledge and belief.
    I sign this verification on this………day of……..at the Court House at……..
Signature of CB
Before me                                                                  Signature of Advocate
Notary