2) Fee a Ae g) Paternal Uncle #1). 2). ~ a 14, Associates and Friends in native state with their address :- 1. 15. Informatjon from Landlord/House owner :- a) Person has been introduced by Shri/Smt. b) Person has been kept by landlord/House owner on its own :~ YES/NO 16. Identity card No. d) Date of Issue b) Valid Upto, d) Issuing authority, 19. Driving License No. a) Date of Issue 4) Issuing authority. b) Valid Upto. 20. Permanent Account No.(Income Tax) Issuing authority. 21.Passport No. a) Date of Issue b) Valid Upto. d) Issuing authority 19.Visa Particulars if any :- 20. Countries visited :- 21 Date of arrival in Goa : 22. Native State : 23. Particulars of arrest and conviction if any : No, & Date Section of Law Police Station Result of case Section of Law Police Station 24. Xerox copy of identity card : Signature of enquiry Officer of P.S.. Name ——— Designation Signature of SHO :-