SubmissionGUID: e53776f2­7106­40ed­9bf1­9d4e66ff00b8

Date: 2023­11­16 09:45 AM

Appointment Date: Nov 19 2023, 10:AM

Certificate of Character Request ­ Cunupia

First Name Last Name Date Of Birth Gender Phone

Andre Samlal 1976/6/30 Male (868) 3585709

Address: Email Address National ID Number Purpose For Which

Required

#245 Mission Road, , Freeport, , TT andresamlal40@gmail.com 19760630009 ­ National ID Taxi Badge Renewal
Card

Racial Origin Complexion Colour Of Hair Colour Of Eyes

East Indian Brown Black Brown

This Space for Identification Branch use

Classification Formula Classified By Searched By Date

Information Checked By Date Certificate Issued Certificate No(S) Results

Signature Of Applicant Signature Of Officer Taking Prints PRINT CERTIFIED CORRECT 1 Signature

PRINT CERTIFIED CORRECT 2 S.D.O I/C STATION Assistant Supt., C.R.O

Fingerprints

1. R. Thumb 2. R. Index 3. . R. Middle 4. R. Ring 5. R. Little

6. L. Thumb 7. L. Index 8. L Middle 9. L. Ring 10. L. Little

LEFT LEFT RIGHT RIGHT

Four Fingers Taken Together Thumb Thumb Four Fingers Taken Together