Scribd
Upload
1K views2 pages

1 3 1 Verification For Tenent FORM

This document contains a form for employers/landlords to provide information about domestic helps, tenants, or employees to the Gurgaon Police. The form requests details such as the employer/landlord's name and contact information, the employee/tenant's personal details like name, age, address, references, and family members. It clarifies that this is just an information form and police verification will be done separately by the concerned police jurisdiction where the employee's permanent address is located.

Uploaded by

Amit Upadhyay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
1K views2 pages

1 3 1 Verification For Tenent FORM

This document contains a form for employers/landlords to provide information about domestic helps, tenants, or employees to the Gurgaon Police. The form requests details such as the employer/landlord's name and contact information, the employee/tenant's personal details like name, age, address, references, and family members. It clarifies that this is just an information form and police verification will be done separately by the concerned police jurisdiction where the employee's permanent address is located.

Uploaded by

Amit Upadhyay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Gurgaon Police

Information on Domestic Help/Tenant/Employee


Particulars of Employer//Landlord
1. Sector/Village/Colony/Society

Passport
Size
Photograph

2. Plot no./Flat No. /House No./Street


No./Police Station
3. Name & Fathers name of Employer/Landlord with Mobile No.
i) Name of the Landlord/Employer
ii) Fathers Name
iii) Contact No.

4.

Signature of the
Applicant

Particulars of Employee/Tenant/Domestic Help

Full Name

Phone No.

Alias
Father Name
Spouse Name

Occupation

Nationality

Age

Sex

Caste

5.

Permanent Address

House No.
Sector/Village/Locality
Police Station
District & State
Landline/ Mobile No.
Proof of Identity (Voter card/Driving License/Ration Card etc.)
Two References from
Native Place (Name,
Address & Ph. No.)

1.
2.

6.

Local (Current) Address

House No.
Sector/Village/Locality

Residing at current address since

Name of Landlord & Address

Police Station
Police Post

Mobile No.
Two Local References

1.

(Name, Address & Ph. No.)

2.

7. Nature of Employment

Place of Work

(Domestic Servant/Shop Employee/Industrial


Worker/Chowkidar/Dhobi/Tradesman/Craftsman
etc.)

8. Particulars of Previous Employment (in case of Employee)


Nature of Employment
Address
Particulars of Previous Employer (with mobile no.)

9. Particulars of Family members residing with the Tenant/Employee


Sr. No.

Name

Age

Sex

Relation

Occupation

Mobile no.

This is only Information Form. I am getting his/her Police


verification done separately by addressing the concerned jurisdiction SP (of permanent
address) in the prescribed Proforma.

Signed by

(Name)
Employers/Landlord.
Dated

You might also like