[PDF] APPLICATION FORM FOR POLICE CLEARANCE CERTIFICATE PDF PoliceCCForm.pdf

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APPLICATION FORM FOR POLICE CLEARANCE CERTIFICATE (PCC) (In respect of applications to be submitted at HCI LONDON OR at CGI BIRMINGHAM OR at CGI EDINBURGH)

1. Full Name: __________________________________________

2. Father's Name and Nationality_______________________________________________

3. Profession of the Applicant__________________________________________________

4. (a) Nationality of the applicant ______________________________________________

(b) Country, Place and Date of Birth __________________________________________

5. Passport Particulars of the Applicant:

Passport No.: _____________________ Place of Issue: ____________________ Date of Issue: _____________________ Date of Expiry: ____________________

6. (i) Pervious nationality (if you have changed your nationality) _____________________

(ii) Particulars of previous passport: Passport No.: _____________________ Place of Issue: _____________________ Date of Issue: _____________________ Date of Expiry: _____________________

7. Have you been to India since you changed your nationality? (Please furnish details, if Yes)

8. Address in India: __________________________________________________________

9. Address in UK: ____________________________________________________________

___________________________________________________POST CODE____________

10. Contact Telephone No.

Mobile no.: _____________ Residence: ______________ Business: __________________ E-mail Address: __________________________________________________________

11. Have you ever been convicted by any court in India or abroad? YES/NO

12. Is there any Police case pending against you in India or abroad? YES/NO

13. Have you received any financial help from the government of India/State Government

or any other institute or organization in India in connection with your visit to UK? If Yes, please furnish details.

14. Have you ever served under the Central/State Government of India? If yes, have you

resigned from your service? (If yes, please attach copy of acceptance letter)

15. FOR NON-INDIAN APPLICANTS:

Place of residence (with full postal addresses) whilst in India, with dates

SI. No. Address where stayed From To

16. Purpose of this application (Delete whichever not applicable):

(i) Wishing to proceed to ______________________________________(country) (ii) For study in (subject) ________________________________________ (iii) For permanent settlement as an immigrant YES/NO (please strike off which is not applicable)

(iv) For seeking employment YES/NO (please strike off which is not applicable)

(v) For any other purpose (state the details)________________________________ I solemnly declare that the information given above is correct and nothing has been concealed and I am aware that it is an offence to knowingly furnish false information or suppress material information. Date:___________________________ Signature: _________________________________ Name:quotesdbs_dbs17.pdfusesText_23

[PDF] [PDF] APPLICATION FORM FOR POLICE CLEARANCE CERTIFICATE