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POLICE_CLEARANCE_CERTIFICATE_FORM

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POLICE_CLEARANCE_CERTIFICATE_FORM Powered By Docstoc
					SUPERINTENDENT OF POLICE
DISTRICT POLICE OFFICE ___________________


________________________________________________________________

            POLICE CLEARANCE CERTIFICATE

            This is to certify that there is nothing adverse in
the district police record against Mr./Ms.
                                                                                  35mm x 35mm
_______________________________________                                A photograph of the
                                                                       application to be pasted
                                                                       here with half the seal
son/daughter/wife of _______________________                           impression on the
                                                                       photograph and half on
                                                                       the application
resident of _______________________________
District_____________ having passport no. ________________issued
on_____by the Regional Passport Officer ________________________
valid upto _________________ during his/her               stay    in      District
___________.
Note: This certificate is issued for use by _________________ Embassy/
Consulate/Immigration Authorities and is not valid for obtaining a fresh
Tatkal passport or for any other purpose.


                                              Superintendent of Police,
                                                   __________.
No. ____________/Sec. Dated__________
Documents attached :__________________________________________

_____________________________________________________________

				
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