OFFICE OF THE DY, COMMISSIONER OF POLICE, SPEULAL BRANCH (1) C.LD, MUMBAI Personal Particulars Form 4) Name in full (in BLOCK LETTERS) with oheses, SURNAME/ STE Nanema ifany api oe em sree} 2) Prusant Sddcess iit full seca apt we 19 Home Address in fol Ge. Wage, Thany, Taluka/ ~ ‘Tahsil aval District or House No, TuneiStree/Rond ind town alengoriti pin eote,) eae et tn Cand eh uae, Brea ae ST =, crevice oath ds ats =) 19) Particulurs of the places (with period of! reidence) —@)—Feom esis on where you have resided during preceding yeors EI eer % singe birth o SUB Sr ee areca aet oho wee fo. corre 5) Tiformation Haine Occupation with address Present address ae cid SRT TT TEE G Father is a jit) Mother . 3 me et ee 18) Date of birth and present age « ae wha word ay, (D Phaee otbirth full addrass) are ne oe wm (8) "Baaeation qualification showing placer of cy cit eclueation with year in schookenlleges. Date of Date af Examination: 2 de ra 2 SIEMPRE entering esving pasted Sea wel wert mia oeeent ote at we eo co) Nome and eddeese of sohooteatlege erarearienre ToT “ cy sa i) BE) K 1089 «50090-2096:Have you aver heen arrestadiprosounteride finoDeouviceed ? Il ea, give gorticulaee of the ease aroure anit er eet advorrer acer Pane ts gra ay Bra ais rer S18 ell sae 9 gHIeHTT Hic) Have nu ever taken active park in polities? 1 sive particulars, oem sell TocaRWR wna Tm Soe ap aE? ORT ‘ae "12) Peownt oecupation/sorvics with all pertiealnes ‘Rare an daft tn ear yp! na, Seas og for obtaining Gravacter and anteculent esetificotr ani i whom it = required ai aaa A Sie Sem eT EA a aan isa y 112) Taeotificatiow aur S14) Names, addresses end signatures of the twa (1) responsible porzons of your loealizy to whom you ave knowa, arse omnis sowie atesore Sea wt, 12) at = aah Toerlify bul Lhe forgoing information is coreoel aud eomplote ta the bast of my knowledge and bole Sort mre ort ae oh, Re a ese ae A Sem ater Femme Tepe Sal: aT. Placs ; MUMBA, et Nase Note Applicaat should athach the following wlomgwitls the anplicution ws ww 3) wy 6 ‘6 Signature of the applicaat. sina? es, A. demand desit of Rs 1001 in the name of Commissioer of Police, Brihan Mumbai wen passport size plratagrazhs, Xerox copy of zation card showing applicant's name ani addres. Yerex copy of the school luaving eortifinate Norox eopy of the passpurt Gi any). Demanding letter from Company/institution, iat — apie ecrtaies meses dit aol aici a i (ey ow oy ® aha sieges, geajed ae ats too sc aber Tees ae rants Ife ela we {amt sieht oeterr® set oT are lee ra Serer Rraesye adie eri seams, aren eiber Shr arash ae os Seu didear ad foe sacar