Fill in Police Clearance Certificate Affidavit

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Police Clearance Certificate Affidavit

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You
Where you have lived
Criminal record and purpose
Signing

Step 1 of 4

You

Where you are ordinarily residentNeeded

the State of Punjabthe Union Territory of Chandigarh

Your full nameNeeded

For example: Simranjit Kaur

Son / daughter / wife ofNeeded

For example: daughter of Sh. Gurmeet Singh

Your addressNeeded

House / flat / plot no.

Street, sector or locality

City area and PIN code

Your photo ID (type and number)Needed

For example: Aadhaar 4444 5555 6666

Your date of birthNeeded

A calendar date — the day, the month and the year. Dates in a document like this are read against one another, so a date typed here can change what another date is allowed to be.

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Your passport number, if you have oneYou may leave this

For example: as printed in your passport

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POLICE CLEARANCE CERTIFICATE AFFIDAVIT

I, __________, __________, resident of __________, holding __________, ordinarily resident within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:

1. MY DETAILS

1.1 I was born on __________.

2. WHERE I HAVE LIVED

3. CRIMINAL RECORD

4. PURPOSE

4.2 I undertake to inform the police and the person or office to whom this affidavit is given if any criminal case is registered against me, or any matter stated above changes, before the clearance is issued or acted upon, and I understand that the clearance may be refused or withdrawn if any statement made here is found false.

5. DECLARATION

5.1 Every statement made above is true to my own knowledge and belief, and I have concealed nothing material to this application. I am aware that making a false declaration in an affidavit is an offence.

VERIFICATION

DEPONENT

Signature: ______________________________
__________

ATTESTATION

Notary Public / Oath Commissioner
Registration No. and seal: ____________________

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