Police Clearance Certificate (For Visa) : Details of 'Saanjh' Kendra

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Facilitation Charges = ` 100/-

PUNJAB TRANSPARENCY AND ACCOUNTABILITY ACT 2018 Stipulated Time = 10 Days

Details of 'Saanjh' Kendra :- Name of Centre

District

Service asked for :- POLICE CLEARANCE CERTIFICATE(FOR VISA)


APPLICANT DETAILS :- Date D D M M Y Y Y Y

Name S/o D/o W/o Relation Name

Alias(s)

Gender Male Female Transgender


Passport
size
Nationality
Photograph Signature
D.O.B

Place of Birth.

Mobile No. E-mail ID.

Passport No. Place of issue.

Date of Issue Valid Upto.

Home/Flat/Plot/Property No. St. No./Name


Present
Address Sector/Village/Colony/Society Pincode

Police Station District State

Home/Flat/Plot/Property No. St. No./Name


Permanent
Sector/Village/Colony/Society Pincode
Address
Police Station District State

Have you ever changed your name Yes No Detail of Name (if Yes)

Whether any Criminal case registered against applicant Yes No

If Yes, details of criminal case registered in India and abroad

Any other Legal/Criminal proceeding initiated against applicant

Purpose of applying service Name of Embassy/Country


(Type of VISA)

Self Attested copy of passport

Photo ID type Self Attested copy of address proof [ Aadhar Card/DL/Voter Card/Any other ________________________ ]
Govt./Bank Issued- Self Attested copy of Birth Proof [Birth Certificate / 10th Certificate/ Any other _______________________]
Passport size photographs 2 Document No.
If you change your name [attested copy of gazette].
NOC is required in case of Govt. Employee.

SELF DECLARATION :-

(I) I Declare that all the above information given by me, is best of my knowledge & belief.
(II) In future if any information found false then any legal action can be taken against me.
(III) I do not take part in any Anti-national/Anti social Activities.
HELP US IN FIGHT AGAINST CORRUPTION
Call Vigilance Bureau Toll Free No. 1800-1800-1000 or visit www.vigilancebureau.punjab.gov.in

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