Office of the

Commissioner of Police
Mysuru City
Karnataka
Government of Karnataka
(Police Department)

POLICE VERIFICATION CERTIFICATE

1. Application Number : PO016S230049709
2. Applicant Name : Koushik S E

3. Father’s/ Husband’s
: Eswarappa
Name

4. Verified Address : No 1081 2nd Stage BEML Layout,

Rajarajeshwari Nagara Mysore,Mysuru City,Karnataka, 570022
5. Period of Stay at
From Date: 01-12-2003 To Date: 10-12-2023
Present Address
6. Permanent Address : No 1081 2nd Stage BEML Layout,
Rajarajeshwari Nagara Mysore,Mysuru City,Karnataka, 570022
: PVC for Training or Apprenticeship at PSU or Trainees or Workers on daily wages
7. Verification Type
at Govt Institutions
8. Date of report
: 11/12/2023
generation
9. Purpose : Appreticeship training at ISRO Bangalore
10. Verified by : SHO of, Saraswathipuram PS

No criminal records has been found against Mr./Mrs./Ms. Koushik S E, since 1995 to till date
11/12/2023 in CCIS and Police IT database available with Karnataka Police. The above person is residing at
above mentioned “Verified address ”.

NOTE: This Certificate is valid for one year from 11/12/2023.

Signature

dgSign2031LocnDyna
DCP LAW
Mysuru City

Reference No: PO016S230049709 To View: https://sevasindhuservices.karnataka.gov.in/t/8Yeub/D4010AC4 Token No: D4010AC4