Ref No:

Applicants Photo

Verification Certificate
This is to certify that Mr. Nachiket S. Deshpande son of Mr. Shreerang V. Deshpande 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. Applicant has been staying at
his address continuously for the last one year.
Date of Birth: 09/03/1989
Place of Birth: Nashik
Educational Qualification: BE Civil (Graduate)
Profession (Govt. /Private Service/Others): Student
Permanent Address: 1302, Cosmos Towers CHS, LBS Marg, Thane West - 400601
Present Address: 1302, Cosmos Towers CHS, LBS Marg, Thane West - 400601
Place: ..
Office Address with location:
Date:
Office Seal
Signature: ........

Full Name: ......

I Card No. : .....
(Enclosed Photocopy of I Card)
Telephone No: (O): .. (R): .
Mobile No: .....
Fax No. : .....
Email ID: ....