HARYANA POLICE GENERAL VERIFICATION SERVICES

¡ǐš™ȡŽȡ”Ǖͧ›  ȡ˜ȡۙ יȡ”“ ȯȡ

CHARACTER VERIFICATION REQUEST

ǐšğĤ˜ȡŽ”ğ\“ǕšȪ’
District ǔ‡›ȡ GURUGRAM

Office Name €ȡ™ȡ[›™€ȡ“ȡ˜ Deputy Commissioner of Police, West Gurgaon

Appplicant Name ]ȯ‘€€ȡ“ȡ˜ Ankur Joshi

Date(Ǒ‘“ȡȲ€ 

Request No.(\“ǕšȪ’ Ȳ 

Request Status \“ǕšȪ’€ȧǔèǓ Registered

UID/Adhar No ™Ǘ]_ŒȢ  Mode of Receiving f€ğ€š“ȯ€ȧͪͬ’ Wireless

Purpose for Applying `Ƨȯæ™ JOB

Relation Type  Ȳ–Ȳ’€ȡĤ€ȡš Father Gender ͧ›Ȳ‚ Male

Relative Name 1 ǐšæȯ‘ȡš€ȡ“ȡ˜ Virender Joshi Landline No. ›ɇŒ›ȡ^““Ȳ–š 

ID Type ”¡ ȡ“€ȡĤ€ȡš Aadhar Card Mobile No. ˜Ȫ–ȡ^› 

Relation Type 2 Ȳ–Ȳ’€ȡĤ€ȡš Self Relative Name 2 ǐšæȯ‘ȡš€ȡ“ȡ˜ Ankur

Challan No.( ȡ›ȡ“ Ȳəȡ 
ID No. ”¡ ȡ“ Ȳəȡ 
Email ID _˜ȯ› 

Passport Issue Place ”ȡ ”ȪŠ[‡ȡšȣ¡Ȫ“ȯ€ȡèȡ“  Passport Issue Date ”ȡ ”ȪŠ[‡ȡšȣǓͬ 

Date of Birth (DD/MM/YYYY) ‡Û˜Ǔͬ  Age (Years/Months) ]™Ǖ Year(s) 11 Month(s)
Present Address [˜ȡ“”ȡ H.No : 369 Street : sarhaul Colony : sector 18 District : GURUGRAM State : HARYANA P.S :
SECTOR-17 / 18 PIN : 122001 TEHSIL : Haryana Village / Town / City : Gurgaon INDIA

Permanent Address èȡ™Ȣ”ȡ H.No : 129 Gali no 43 Street : sadh nagar Colony : palam colony District : SOUTH WEST State :
DELHI P.S : PALAM VILLAGE PIN : 110045 TEHSIL : delhi Village / Town / City : delhi INDIA

Is there any criminal records against you or your family? șȡ]”€ȡ™ȡ]”€ȯ”ǐšȡš€ȯͨ›ȡ•€Ȫ_]”šȡͬ’€€ȡ™[ȡ¡ȣ

¡Ȱ! No

If Yes, Provide Details ™Ǒ‘¡ȡȱͪšŽĤ‘ȡ“€šɅ 

Office Name €ȡ™ȡ[›™€ȡ“ȡ˜ Deputy Commissioner of Police, West Gurgaon

Username : Ĥ™Ȫȏȡ“ȡ˜  20/11/2023

 HARYANA POLICE GENERAL VERIFICATION SERVICES
¡ǐš™ȡŽȡ”Ǖͧ›  ȡ˜ȡۙ יȡ”“ ȯȡ

CHARACTER VERIFICATION REQUEST

ǐšğĤ˜ȡŽ”ğ\“ǕšȪ’
All the information provided in the form is true? a”š‘ȣ‚_ —Ȣ‡ȡ“€ȡšȣ ¡ȣ¡Ȱ! Yes

Office Name €ȡ™ȡ[›™€ȡ“ȡ˜ Deputy Commissioner of Police, West Gurgaon

Username : Ĥ™Ȫȏȡ“ȡ˜  20/11/2023