ANNEXURE ‘F’
SPECIMEN VERIFICATION CERTIFICATE (FOR PASSPORT UNDER TATKAAL ONLY) (On official letter head of verifying authority)
(To be given in Duplicate* along with Standard Affidavit as at Annexure “I”)
Reference Number Applicant’s Photo
Verification Certificate
This is to certify that Sh./Smt./Kum. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. son/wife/daughter of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. whose personal particulars are given below, has good moral character and reputation and that after having read the provisions of Section 6(2) of the Passports Act, 1967, I certify that these provisions are not attracted in case of this applicant and I, recommend issue of an Indian Passport to him/her. Applicant has been staying at his/her address continuously for the last one year.
| Date of Birth | _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| Place of Birth | _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| Educational Qualification | _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| Profession (Govt./Private Service/Others) | _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| Permanent Address | _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| Present Address | _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
| Place Office Address with location Date: |
Signature Office Seal |
| Full Name _ _ _ _ _ _ _ _ _ _ _ _ Designation _ _ _ _ _ _ _ _ _ _ _ _ I Card No. _ _ _ _ _ _ _ _ _ _ _ _ (Enclose a photocopy of I Card) Telephone No. (O)_ _ _ _ _ _ _ _ _ _ _ _ (R)_ _ _ _ _ _ _ _ _ _ _ _ Mobile No _ _ _ _ _ _ _ _ _ _ _ _ |