[PDF] DOMESTIC SERVANT/EMPLOYEE VERIFICATION FORM





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What are the benefits of Police Verification?

    Police verification helps to avoid any future personal liability of landlord and to enforce liability on tenant if the tenant makes the damage to the property or commits a crime or is an offender or terrorist. 1.

What is the DIB police verification for passport?

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DOMESTIC SERVANT/EMPLOYEE VERIFICATION FORM

PART I

SL. No. ____________POLICE STATION _______________ DISTRICT __________

DETAILS OF SERVANT/EMPLOYEE

1. Name of the Servant/Employee (with alias, if any)

_______________________________________

2. ame ___________________________________________________

3. ___________________

4. Place & Date of Birth _____________________________________________

5. Language spoken ________________________________________________

6. Permanent Address

__________________Vill.________ ___________________________________ PO___________________ P.S_________________________ District _____________________ State ____________________Country ____________________ Tel._______________________

7. Details of identification proof like Ration Card/Driving Licence/I.Card, if any _______________

____________

8. Name & Address of the Sarpanch _________________________________________________

9. Local Address _________________________________________________________________

10. Name & address of previous employer in Delhi

___________________________________________________________Tel. No. ____________

11. Date since when employed

Photograph of

Servant/Employee

12. A specialization obtained in which area of domestic help like :-

(i) Cooking ________________________________________________________________ (ii) Dusting & Utensil cleaning _________________________________________________ (iii) Outdoor works ___________________________________________________________ (iv) Attending guest/visitors ____________________________________________________ (v) Attending phone calls _____________________________________________________ (vi) Any other (Please specify) __________________________________________________

13. DESCRIPTION OF EMPLOYEE

(i) Height ___________ (ii) Built _____________________________(iii) Eyes ________________ (iv) Hairs ____________ (v) Complexion _______________(vi) Tatoo Marks __________________ (vii) Other identification Marks _________________________________________________ (viii) Deformity or peculiarity if any _______________________________________________ (ix) Petwords of speech _____________________________ (x) Physical Built __________________ (x) Handwriting specimen ___________________________________________________________ (xi) Signature of the employee/servant __________________________________________________

14. Name & Local Address of Relatives & Friends in Delhi ________________________________

15. INTRODUCED BY:-

Name, Address & Telphone No. ____________________________________________________

16. DETAILS OF EMPLOYER

Name, Address & Telephone No. ___________________________________________________

Signature of the Employer

PART II - A

FINGER PRINT IMPRESSION OF EMPLOYEE/SERVANT

(voluntarily given to the employer) (To be filled up by Employer only)

1. Full name with aliases ___________________________________________________________

2. _______________________________________

3. Address _______________________________________________________________________

4. Police Station Sl. No. ____________________________________________________________

FINGER PRINT IMPRESSION OF SERVANT/EMPLOYEE

RIGHT HAND

Right Thumb Right Index Right Middle Right Ring Right Little

LEFT HAND

Left Little Left Ring Left Middle Left Index Left Thumb

Signature of employee

Signature of employer

PART II B

RIGHT HAND IMPRESSION OF THE SERVANT/EMPLOYEE

Plain prints of four fingers & thumbs taken simultaneously (Voluntarily given to the employer) (To be filled up by Employer only)

Signature of employee

Signature of employer

PART II C

LEFT HAND IMPRESSION OF THE SERVANT/EMPLOYEE

Plain prints of four fingers & thumbs taken simultaneously (Voluntarily given to the employer) (To be filled up by Employer only)

Signature of employee

Signature of employer

FOR POLICE USE ONLY

PART III

1. Form Prepared by

Name : ______________________________________ Rank ___________________________ Range No. ____________________________________ PIS No. _________________________ Police Station _________________________________ District __________________________

2. Result of verification from CRO ___________________________________________________

3. Result of verification from Finger Print Bureau _______________________________________

4. Result of verification from previous employers ________________________________________

5. Result of verification from the concerned Police Station _________________________________

(of Delhi to be done local PS)

6. Details of verification form sent to DCP office for enquiry from SHO Home Town

PS ____________________________ District ______________________ State ________________ Despatch No. _____________________ Date ___________________

S.H.O __________________________

7. Result of verification from home town /Date & details of verification received from home town

S.H.O __________________________

ACKNOWLEGEMENT

Received Servant/Employee verification form from Sh./Smt. __________________________________ in favour of Sh./Smt. __________________________________on ______________.

Signature of Duty officer

PS __________________

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