(On official stationery of verifying authority)
(To be given in Duplicate* along with the Standard Affidavit as at Annexure "I"
Reference Number
Verification Certificate issuing officer should attest the photograph of the applicant with his/her signature and rubber stamp in such a way that half the signature and stamp appear on the photograph and half on the certificate).
Verification Certificate
This is to certify that Sh./Smt./Kum. ……………………….. son of/wife of/daughter of …………………. whose personal particulars are given below has good moral character and reputation and that after having read the provisions of Section 6(2) of the Passports Act, 1967. I certify that these provisions are not attracted in case of this applicant and I, recommend issue of an Indian Passport to him/her. Applicant has been staying at his/her address continuously for the last one year.
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Date of Birth
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Place of Birth
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Educational Qualification
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Profession (Govt./Private Service/Others)
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Permanent Address
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Present Address
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Place
Office Address with location
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Date:
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Signature ..................
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Full Name ..................
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Designation ..................
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I Card No ..................
(Enclose a photocopy of I Card)
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Telephone No. (O) ............. (R) ..........
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Mobile No ..................
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