PERSONAL INFORMATION OF TENANT/TEMPORARY RESIDENT

PHOTO 1) Tenants/Occupants Name & Address: 2) Duration at present Address: 3) Jurisdiction of Police Station: 4) Permanent Address: 5) Tenant/Occupants Date of Birth: 6) Place of Birth: 7) Present Age: 8) Details of Earlier Residential Addresses till Date: a) Place b) Time c) Jurisdiction of Police Station

9) Fathers Name, Address and Occupation:

10) Present Occupation:

11) If employed a) Where ? b) Since when? c) period

12) Identification Mark: 13) Name and Address of Two Respectable citizens of Pune Police Commissionerate Known to Tenants/Occupants 1: 2: 14) Details Of Criminal Offences Registered: a) C. R. No. and Section: b) Whether arrested: c) Present status of case:

I, the Tenant/Occupant do state on solemn affirmation that the above given information is true and correct. Place: Date: Tenants/Occupants Signature

(Note:-Please enclose letter from employer, copies of photo Identify card i.e. MDL/PASSPORT/I-CARD/PAN CARD ETC)