Government
of India
Ministry of External Affairs
CPV Division, Delhi
Ministry of External Affairs
CPV Division, Delhi
ANNEXURE ‘F’
SPECIMEN VERIFICATION CERTIFICATE (FOR PASSPORT UNDER TATKAL ONLY)
(On
official stationery of verifying authority)
(To be
given in Duplicate* along with Standard Affidavit as at
Annexure “I” )
Reference Number
Applicant’s Photo
|
(Verification Certificate issuing officer should attest the photograph
of the applicant with his/her signature and rubber stamp in such a way that half
the signature and stamp appear on the photograph and half on the certificate).
Verification Certificate
This is to certify that Sh./Smt./Kum. ……………………….. son of/wife of/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………………………………
Notes:
1. The applicant’s passport size
photograph is also required to be affixed on the Verification Certificate and
attested by the officer issuing the Verification Certificate with his/her
signature and rubber stamp in such a way that half the signature and stamp
appear on the photograph and half on the certificate.
2. If the applicant has resided at more
than one place during the last one year then all previous addresses with the
relevant dates should be mentioned.
3. This Verification Certificate may be
got signed by any of the following:
(i) An Under
Secretary/Deputy Secretary/Director/Joint Secretary/Add. Secretary/Special
Secretary/Secretary/Cabinet Secretary to Government of India.
(ii) A Director/Joint
Secretary/Additional Secretary/Special Secretary/Chief Secretary to a State
Govt.
(iii) A Sub-Divisional Magistrate/First class Judicial
Magistrate/Additional DM/District Magistrate of the district of residence of
applicant.
(iv) A
District Superintendent of Police, DIG/IG/DGP of district of residence of
applicant.
(v) A Major and above in the army, Lt. Commander and above in
the Navy and Sq. Leader and in the Air Force.
(vi) The General Manager of a Public Sector Undertaking
(vii) All members of any All India Service or Central Service who
are equivalent to or above the rank of an Under Secretary to the Government i.e. in the pay scale of Rupees 10,000-15,200 or
above.
(viii) Resident Commissioners/Additional Resident
Commissioners of all State Governments based in
Delhi.
(ix) Concerned Tehsildars or Concerned SHO’s for an
applicant staying in the area under his/her jurisdiction.
(x) The Chairmen of the Apex Business
Organizations i.e.FICCI, CII and ASSOCHAM in respect of owners, partners
or directors of the companies that are members of the concerned Chamber
in prescribed performa as at
Annexure “J”.
4. Anyone
who issues incorrect verification certificate may be prosecuted under section
12(2) of the Passport Act, 1967.
5. 5. SECTION 6(2) (C) OF THE PASSPORT ACT, 1967
“Subject to the other provisions of this Act, the passport authority
shall refuse to issue a passport or travel document for visiting any foreign
country under clause ( C ) sub-section 5 of anyone or more of the following
grounds, and on no other ground, namely:
(a) that the applicant is not a citizen of
India.
(b)
that
the applicant may, or is likely to engage outside India in activities
prejudicial to the sovereignty and integrity of India.
(c)
that
the departure of the applicant from India may, or is likely to be detrimental to
the security of India.
(d)
that
the presence of the applicant outside India may, or is likely to prejudice the
friendly relations of India with any foreign country.
(e)
that
the applicant has, at any time during the period of five years immediately
preceding the date of his application been convicted by a court of India for any
offence involving moral turpitude and sentenced in respect thereof imprisonment
for not less than two years.
(f)
that
criminal proceedings in respect of an offence alleged to have been committed by
the applicant are pending before a court in India.
(g)
that
a warrant or summons for the appearance, of a warrant for the arrest, of the
applicant has been issued by a court under any law for the time being in force
or that an order prohibiting the departure from India of the applicant has been
made by any such court.
(h)
That
the applicant has been repatriated and has not reimbursed the expenditure
incurred in connection with such repatriation.
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