Kaagazaat

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Employee Police Verification Form

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  1. You, the employer
  2. The employee to be verified
  3. Previous employment and references
  4. Submission details

Step 1 of 4

You, the employer

For example: Karamjeet Singh Bajwa

You are applying asNeeded
Your address, or the address of the premises the employee will work atNeeded

A number somebody can be reached on. Ten digits is the usual Indian form, and a country code in front of it is fine if you want it there.

For example: 98140 12345

For example: Police Station Sector 26, Chandigarh

More details — you may leave these

For example: Ritu Mahajan

For example: Secretary, authorised by the Managing Committee resolution dated 2 March 2026

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APPLICATION FOR POLICE VERIFICATION

To,
The Station House Officer,
Police Station __________.

Date: __________
Place: __________

Subject: Application for antecedent and character verification of __________, engaged/proposed to be engaged as __________

Sir/Madam,

  1. I, __________, __________, of __________, phone __________, have engaged, or propose to engage, the person named below, and request that their antecedents and character be verified before or during that engagement.
  1. PARTICULARS OF THE EMPLOYEE

Name: __________
Nature of engagement:
Father's/husband's name: __________
Date of birth/age: __________
Permanent address: __________
Present address: __________
Identity proof produced: __________, number __________
Contact number: __________
Date from which engaged/proposed to be engaged: __________

  1. PREVIOUS EMPLOYMENT, REFERENCE AND AGENCY, IF ANY
  1. UNDERTAKING BY THE EMPLOYER

I undertake to inform this police station in writing if the engagement ends, if the employee's address changes to my knowledge, or if anything bearing on the employee's character comes to my notice during the engagement. I understand that engaging this person before verification is complete is at my own risk, and that this application does not itself certify the employee's character until the police station's report is received.

  1. CONSENT AND DECLARATION BY THE EMPLOYEE

I, __________, confirm that the particulars given about me above are true to the best of my knowledge, and I consent to the police verifying my antecedents at the addresses given above and with the previous employer and reference named, for the purpose of this engagement. I understand that furnishing false particulars is an offence.

Signature of the employee: ______________________
Name: __________
Date: __________

  1. DOCUMENTS ATTACHED

Self-attested photocopy of the identity proof named in item 2; two recent passport-size photographs of the employee.

Signature of the applicant/employer: ______________________
__________
Address: __________
Phone: __________

FOR POLICE USE ONLY — NOT TO BE FILLED BY THE APPLICANT

Application/portal reference number: ____________________
Report called for from Police Station: ____________________ on: ____________________
Verification report received on: ____________________
Remarks: ____________________________________________________________
Verifying Officer's name, rank and signature: ____________________________________________________________

The rest stays out of view until every answer is in.

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APPLICATION FOR POLICE VERIFICATION

To,
The Station House Officer,
Police Station __________.

Date: __________
Place: __________

Subject: Application for antecedent and character verification of __________, engaged/proposed to be engaged as __________

Sir/Madam,

  1. I, __________, __________, of __________, phone __________, have engaged, or propose to engage, the person named below, and request that their antecedents and character be verified before or during that engagement.
  1. PARTICULARS OF THE EMPLOYEE

Name: __________
Nature of engagement:
Father's/husband's name: __________
Date of birth/age: __________
Permanent address: __________
Present address: __________
Identity proof produced: __________, number __________
Contact number: __________
Date from which engaged/proposed to be engaged: __________

  1. PREVIOUS EMPLOYMENT, REFERENCE AND AGENCY, IF ANY
  1. UNDERTAKING BY THE EMPLOYER

I undertake to inform this police station in writing if the engagement ends, if the employee's address changes to my knowledge, or if anything bearing on the employee's character comes to my notice during the engagement. I understand that engaging this person before verification is complete is at my own risk, and that this application does not itself certify the employee's character until the police station's report is received.

  1. CONSENT AND DECLARATION BY THE EMPLOYEE

I, __________, confirm that the particulars given about me above are true to the best of my knowledge, and I consent to the police verifying my antecedents at the addresses given above and with the previous employer and reference named, for the purpose of this engagement. I understand that furnishing false particulars is an offence.

Signature of the employee: ______________________
Name: __________
Date: __________

  1. DOCUMENTS ATTACHED

Self-attested photocopy of the identity proof named in item 2; two recent passport-size photographs of the employee.

Signature of the applicant/employer: ______________________
__________
Address: __________
Phone: __________

FOR POLICE USE ONLY — NOT TO BE FILLED BY THE APPLICANT

Application/portal reference number: ____________________
Report called for from Police Station: ____________________ on: ____________________
Verification report received on: ____________________
Remarks: ____________________________________________________________
Verifying Officer's name, rank and signature: ____________________________________________________________

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