OFFICE OF THE DY. COMMISSIONER OF POLICE ... - Mumbai Police
OFFICE OF THE DY. COMMISSIONER OF POLICE ... - Mumbai Police
OFFICE OF THE DY. COMMISSIONER OF POLICE ... - Mumbai Police
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<strong><strong>OF</strong>FICE</strong> <strong>OF</strong> <strong>THE</strong> <strong>DY</strong>. <strong>COMMISSIONER</strong> <strong>OF</strong> <strong>POLICE</strong> SPECIAL BRANCH (I),<br />
C.I.D., MUMBAI<br />
(1)<br />
(2)<br />
(3)<br />
(4)<br />
Personal Particulars Form<br />
Name in full ( IN BLOCK LETTER ) with SURNAME NAME<br />
aliases if any<br />
laiw.kZ uko ¼izFke vkMuko½<br />
……………………………………………………….<br />
Present Address in full ……………………………………………………….<br />
l/;kpk laiw.kZ iRrk<br />
Home Address in full (i.e. Village, Thana,<br />
Taluka/ Tahsil and District or House No.<br />
Lane/Street/Road and town alongwith pin<br />
code.)<br />
xkokpk iw.kZ iRrk ¼vFkkZr xko] Bk.ks] rkyqdk] ftYgk<br />
rlsp ?kj ua- xYyh@ysu@jLrk vkf.k ihu dksM ua½<br />
……………………………………………………….<br />
…………………………………………………….…<br />
………………………………………………………<br />
Particulars of the places (with period of (i) From …………………….to……………..<br />
residence) where you have resided during<br />
iklwu --------------------------------rs---------------------preceding<br />
years since birth.<br />
iRrk % ------------------------------------------<br />
;k iwohZ vki.k jgkr vlysY;k tkxspk iw.kZ iRrk o<br />
dkyko/kh ¼tUekiklwu½<br />
(ii)<br />
(iii)<br />
………………………………….<br />
………………………………….<br />
(5) Information Name Occupation with address Present address<br />
ekfgrh uko O;olk; o iRrk l/;kpk iRrk<br />
(i) Father ……………………………………………………………………………………...<br />
oMhy ……………………………………………………………………………………...<br />
(ii) Mother ……………………………………………………………………………………...<br />
vkbZ ……………………………………………………………………………………...<br />
(iii) Husband/ Wife ……………………………………………………………………………………...<br />
irh@iRuh ……………………………………………………………………………………...<br />
(iv) Brother ……………………………………………………………………………………...<br />
HkkÅ ……………………………………………………………………………………...<br />
(v) Sister ……………………………………………………………………………………...<br />
cgh.k ……………………………………………………………………………………...<br />
(6) Date of birth and present age …………………………………………………..<br />
tUe rkjh[k o l/;kps o;<br />
(7) Place of birth ( full address ) ………………………………………………………………………….<br />
tUeLFkku ¼iw.kZ iRrk ½ ………………………………………………………………………….<br />
(8) Education qualification showing places of (i) (ii) (iii)<br />
education with year in school/colleges. Date of Date of Examination<br />
entering leaving passed<br />
izos'kkph rkjh[k<br />
(iv)<br />
lksMY;kph rkjh[k dks.krh ijh{kk ikl dsyh<br />
Name and address of<br />
school/college.<br />
'kkGk@egkfon;ky;kpk iRrk<br />
(i)<br />
(G.C.P.) K 1980 (50,000&2-06)<br />
(ii)<br />
(iii)<br />
(iv)
(2)<br />
(9) Have you ever been arrested/prosecuted/ detained/<br />
fined/convicted? If so, give particulars of the case<br />
vki.kkl d/kh vVd >kyh gksrh@[kVyk pkyyk<br />
gksrk@LFkkuc/n dsys gksrs@naM >kyk gksrk fdaok dksVkZr<br />
f'k{kk >kyh gksrh dk;\ vlY;kl dslph ekfgrh FkksMD;kr<br />
fygk-<br />
(10) Have you ever taken active part in politics ? If so,<br />
give particulars.<br />
vki.k d/kh jktdkj.kkr lfØ; Hkkx ?ksryk vkgs dk; \<br />
vlY;kl ri'khy n;kok-<br />
(11) Present occupation/service with all particulars<br />
l/;kpk vkiyk /kank@uksdjh o R;kpk iw.kZ ri'khy<br />
(12) Reasoning for obtaining character and antecedent<br />
certificate and to whom it is required.<br />
pkfjå; iMrkG.kh o iwoZ bfrgkl vgoky d'kkdfjrk<br />
ikfgts vkgs o dks.kR;k fBdk.kh \<br />
(13) Identification Mark<br />
vksG[k fpUg<br />
(14) Names, addresses and signatures of the two<br />
responsible persons of your locality to whom you<br />
Place :<br />
tkxk %<br />
Date :<br />
fnukad %<br />
are known<br />
vkiY;k Hkkxkrhy vki.kkal vksG[k.kkÚ;k nksu lnx`gLFkkaph<br />
ukaos] laiw.kZ iRrk o Lok{kjh-<br />
I certify that the forgoing information is correct and complete to the best of my knowledge and belief<br />
eh vls izek.ki= tkghj djrks dh] ojhy uewn dsysyh ekfgrh gh ekÖ;k lakax.;kuqlkj o fo'oklkizek.ks vpwd vkf.k iw.kZ vkgs-<br />
Note - Applicant should attach the following alongwith the application :-<br />
lwpuk -<br />
(1)<br />
(2)<br />
Signature of the applicant<br />
vtZnkjkph Lok{kjh<br />
(1) A demand draft of Rs. 100 in the name of Commissioner of <strong>Police</strong>, Brihan <strong>Mumbai</strong><br />
(2) Two passport size photographs.<br />
(3) Xerox copy of ration card showing applicant's name and address.<br />
(4) Xerox copy of the school leaving certificate.<br />
(5) Xerox copy of the passport (if any).<br />
(6) Demanding letter from Company/Institution.<br />
vtZnkjkus vtkZlkscr [kkyhy uewn dsysyh lgi=s tksMkohr %&<br />
¼1½ iksyhl vk;qDr] c`gUeqacbZ ;kaps ukos 100 :Ik;kapk cWadspk fMekaM MªkV<br />
¼2½ ikliksVZ lkbZtps nksu QksVks<br />
¼3½ js'ku dkMkZph vtZnkjkps uko o iRrk vlysyh >sjkWDl izr-<br />
¼4½ 'kkGk lksMY;kP;k nk[kY;kph >sjkWDl izr-<br />
¼5½ ikliksVZ vlY;kl] R;kP;k ifgY;k nksu ikukaph >sjkWDl izr-<br />
¼6½ daiuh @laLFkk ;kaps pkfj«; iMrkG.kh ekx.khi=
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