Application for Police Clearance Certificate - Canada
HCI Ottawa/ CGI Toronto/ CGI Vancouver
Application for Police Clearance Certificate
1. Mr./Mrs./Ms. :_________________________________________
2. Father's Name :_________________________________________
3. Spouse's name :_________________________________________
4. Date and Place of Birth :_________________________________________
5. Occupation :_________________________________________
6. Present Nationality :_________________________________________
7. Current Passport No :_________________________________________
8. Date & Place of Issue
9. If you are not a citizen of India now,
were you a citizen of India formerly? :_________________________________________
If so also give
Indian Passport No :_________________________________________
Place of Issue :_________________________________________
Place and issue :_________________________________________
10. Address in India :_________________________________________
11. Address in Canada :_________________________________________
12. Marital Status :_________________________________________
13. Telephone – Business :_________________________________________
14. Purpose for which the Certificate is
required :_________________________________________
15. Name of sponsoring authority :_________________________________________
if any and plan scheme under which :_________________________________________
you came to Canada
16. 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? _________________________________________
17. Have you ever been convicted by
any court in India or abroad? :_________________________________________
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