I POLICE VERIFICATION FORM FOR

ISSUANCE OF AIRPORT ENTRY PASS

Photograph
1. Name of Applicant. ....,-
(IN BLOCK LETTERS)
2. Father's /Husband's Name _ (Passport Size)
3. Educational Qualification _
2" x 1112"
4. Date & Place of Birth _

5. Nationality. Religion. _
(For Pakistani National)

6. CNIC No. Passport No (If any). ~ _

7. Present Address _

8. Permanent Residential Address: _

9. Present Appointment Previous Service (If any) --

10. Political Affiliation in the Past any Activity in

Any Political/Student / Labour Organization ~ _

11. Name & Addresses of Two Relatives "'--_-'-- -------------

a.
b.

12. I hereby certify that the particulars given above area correct to the best of my knowledge and belief.

Signature of Applicant
Date _

Mobile No. _

COUNTERSIGNED BY THE HEAD OF OEPTT / NOMINATED OFFICER

CHARACTER CERTIFICATE (Nazim, Councilor, Army / Government Gazetted Officer)

C"i~~., ,'.~.
_ V·i~~'~
-
G;~-"~},

Signature & Stamp

Name. .
Designation. _

FOR OFFICIAL USE ONLY (Police Station)

Cleared l Not cleared for the following reasons;

Signature & Stamp

SHOo _
Police Station.
Date. , _
(Do not use the back Side of this pace, use extra page with page numbering in case of additional work)
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