yer aways
10,
ul
12,
1B.
14,
17,
. Name of sponsoring authority
HCI Ottawa/ CGI Toronto/ CGI Vancouver
lication for Police Clearance Certificate
Mr/Mrs./Ms. EEEEEPPEEEEC
Father's Name
Spouse's name
Date and Place of
Occupation
Present Nationality
Current Passport No
Date & Place of Issue
Ifyou are not a citizen of India now,
were you a citizen of India formerly?
Ifs0 also give
Indian Passport No
Place of Issue
Place and issue
Address in India
‘Address in Canada
Marital Status
Telephone — Business
Purpose for which the Certificate is
required
if any and plan scheme under which :
you came to Canada
. Have you received any financial
help from the government of India /
state government or any other
institute or Organisation in India in
connection with your visit to
Canada?
Have you ever been convicted by
any court in India or abroad?18. Have you ever served under the
Central / State Government of
India? If yes, have you resigned?
your service (attach copy of
acceptance letter)
19, Have you visited / stayed in India
after acquisition of landed status
/ foreign
20.
S.No] Address where stayed From To
Date:
Signature of Applicant:
Time taken: Issue of Police Clearance Certificate requires references to authorities
in India and elsewhere and therefore a minimum processing time of 6 weeks is
required to issue.