Police Verification Form

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APPLICATION FORM FOR CHARACTER CERTIFICATE/ANTECEDENT

Gender:
Dob (mm/dd/yyyy):
Marital Status:
Educational Qualification:
Note: Address in the document should tally with the present address given.
Proof of Address:
Sellect Village/Town: Police Station:
Purpose for Applying:
Photo:
(Max image size 150 KB) H:316px, W:317px
Signature:
(Max image size 150 KB) H:50px, W:200px

IMPORTANT: Document to be submitted at the office during collection of final POLICE VERIFICATION CERTIFICATE (PVR)