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Applicationform For Police Verification

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Anuj Raj Sahu
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203 views1 page

Applicationform For Police Verification

Uploaded by

Anuj Raj Sahu
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
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CHARACTER AND ANTECEDENTS VERIFICATION REPORT (APPLICATION FORM)

To
The Superintendent of Police,
District Police Office, _____________.

Subject: Application for Employee Verification


Sir,
It is requested that I have been selected as…………………………..in Aryavart Bank, a Bank constituted under
the RRB Act,1976 and having its Head Office at A-2/46, Vijay Khand, Gomti Nagar, Lucknow 226 010. The Bank
requires that my character and antecedents may be verified and a Police Verification Report may be issued to
me. My personal particulars are as follows:
1- Full Name (Expanded Initials)………………………………………………………………………………………………………..
Alias (If any)…………………………………………………..
2- Father (Full Name)…………………………………………………………………………………………………………………………
3- Spouse (Full Name), if married……………………………………………………………………………………………………….
4- Occupation………………………………………………………..
5- Nationality……………………………Age……………………………..Sex…………………………… Caste……………………………
6- Mobile No…………………………………………………..
7- Permanent Address:-
H.No……………………………….. Sector/Village/Locality…………………………………………
Self
Police Station……………………………………… District………………………………………………
attested
State…………………………………………………… Pincode…………………………………………….
photograph
8- Proof of Identity (Voter Card/ Driving Licence/ Ration Card etc)
9- Local (Current Address)……………………………………………………………………………………
…………………………………………………………………………………..
.…………………………………………………………………………………
…………………………………………………………………………………….
Residing at current Address since…………………………………………………….
10- Particulars of Previous Employment, if any
Nature of Employment ………………………………………………………………….
Address………………………………………………………………………………………….
………………………………………………………………………………………….
………………………………………………………………………………………….
Particulars of Previous Employer…………………………………………………..
11- Particulars of relatives residing locally Local (Current) Address

S.No. Name Father’s Name Occupation Local Address


1 ………………………………… …………………………….. …………………… ………………………………
2 ………………………………… …………………………….. …………………… ………………………………
3 ……………………………… …………………………….. …………………… ………………………………

(Signature of Applicant)
---------------------------------------------------------------------------------------------------------------------------------------------------
(For use of S.P. Office)

Name of the Applicant……………………………………………………………… Father/Husband’s


Self
Name…………………………………………………………..
attested
Address…………………………………………………………………………………….. photograph
……………………………………………………………………………………...
………………………………………………………………………………………
……………………………………………………………………………………….

Report………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….

(Signature of the issuing Authority)


Official Seal

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