R Membership Form

CRIME INVESTIGATION AGENCY

{Regd. Under Indian Trust Act 1882} Reg No: 817-4-2016

Ref By _ _ _ _ _ _ Date _ _ _ _ _
Website : www.ciaindia.org.in Rule & Regulation Of CIA
Email : info@ciaindia.org.in 1. The Members and Officers Of CIA are working on
Contact : 09919233128, 08840457967, member basis and no payment is given to them.
09839112790 Membership is non-transferable and once the payment
To, is made, it is non - refundable.
The Chairman 2. CIA will not be responsible for any misuse of identitycard
issued to the Membership during the course of their
Crime Investigation Agency Membership of CIA.
Head Office: First Floor Karmat Market 3. In case of loss the identitycard inform the headoffice.
Nishatgang Lucknow Office in writting An Application along with the F.I.R.
Corp Office: Khargupur Bazar Gonda U.P. 271204 immediatley.
Zonal Office: Gandhi Nagar Utraula Distt-Balrampur 4. Any kind of misbehaviour, result in rejection of
Membership of CIA.
Name : . 5. On expiry the identity-card must be submit to head office
Father’s Name : . and will have renewed.
Date Of Birth : . 6. Strict action will be taken against member if found guilty
Height Cm : . floating the rules and regulation of the CIA.
Blood Group : . 7. All CIA members should contact their respective area units,
Profession : . zonal units, state units, office in a month.
Education : . 8. If you have anu doubt, questions or problems, please
contact CIA head office/officers.
Mailing Address : .
9. All the disputes subject to jurisdiction Gonda.
. 10. All the rights reserved to CIA.
Po. Distt .
State Pin Code . Bank Details:
Nearest Police Station . Crime Investigation Agency
Tel Mob . Account No: 50379196975
E-Mail . IFSC: ALLA 0210382
Details Of Bank Draft / Cheque . Bank Name: ALLAHABAD BANK
. Khargupur Bazar Gonda U.P.271204
Date ........... MEMBERSHIP FEE
1- Members / Distt. Members 1550
Place .......... Signature 2- Zonal Member 4000
Declaration: I hereby solemnly affirm and declare that : 3- State Member 15000
1. The particulars Mentioned by me here in above are
true & correct to thr best of my knowledge and nothing 4- Lifetime Member 30000
Name / Signature of
has been concealed or supressed thereof. If anything Attesting Authority with office seal
found incorrect at any stage, my membership may be For Office Use
terminated. Unique Id : ......................................
2. I honestly declare that I will not involve myself
directly or indirectly in any act which will be against
Post : ...............................................
the prestige of our Nation, Society, journalism and Work Area : .....................................
CIA as well. Minimum Qualification
3. In case of chnage of address / mobile no. Member
General Member:- High School
should inform the same to the National Head office.
Special Member :- Intermediate
Essential Documents
Date ………… ID Proof, Residential Proof, Affidavit,
Place ………... Signature 4 Photo, Educational Documents
To,
TheCorp office ,
Crime Investigation Agency,
Khargupur Bazar Gonda U.P 271204.
Dear Sir,
I ……….............................................................. S/O, D/O, W/O ................................................................... R/O
…………………………………………………………………………………………………………………………

Applying for the membership of Crime Investigation Agency do hereby solemnly firm/declare/certify as under:
1. I will follow all the rules & regulations of CIA as per the membership form.
2. I do not have any criminal background & do not have any criminal FIR/Case lodged/pending against me.
3. CIA will not be responsible for any/such illegal/wrong/immoral act for omission done by me.
4. Whenever required I will present my Identity Card/ Certificate.
5. I will never misuse my membership/ Identity Card.
6. The Chairman of CIA reserve the right to reject any membership form without assigning any reason.
7. The Chairman of CIA may terminate/ cancel/ suspend the membership without any prior intimation/
information/ reason.
8. In case the above submitted information is found incorrect/ false, I will be subject to the law of the land and the
Chairman reserves the right to cancel the membership form without assigning any reason.
9. I have read & understood the terms & conditions and undertake to comply with them.

Deponent
Verification
Verified that the above statement is true and correct to the best of my knowledge and belief. Nothing has
been concealed therein.

Date :

Place : Deponent