(On the Official Letterhead)

PCC Ref.No:

POLICE CLEARNACE CERTIFICATE

This police clearance certificate is to officially certify the ‘criminal records’ of (Your

Full Name), who is an Indian national, currently holding a valid Indian passport (Your

Current Passport Number), which has been issued by (Passport Issuing Authority,

Place of Issue, Country), issued on (Date of Issue) and valid upto (Date of Expiry).

(Your Full Name) is a permanent resident of (Your Permanent Address with House

Number or House Name, Street Name, Colony/Area, City/Town/Village, District,

State, Country and Postcode).

(Your Full Name) is currently residing at (Your Current Address with House Number

or House Name, Street Name, Colony/Area, City/Town/Village, District, State,

Country and Postcode) since (Month, Year).

Upon detailed verification of police records, we have found nothing adverse recorded

against (Your Name) during the period of stay from (Date) to till date in the above

mentioned permanent resident address in India. Also, (Your Full Name) does not have

impending criminal prosecution and generally considered a person of good character

in the society.

NOTE: This police clearance certificate is valid for six months from the date of issue.

No correction can be made to this police clearance certificate. Any visible correction

or physical damage will automatically make this police clearance certificate void and

must not be accepted for whatsoever purpose in India or Abroad.

Place of Issue: Date of Issue:

Signature:

Full Name of the Officer: Official Seal:

Designation of the Officer:

Contact Phone Number:

Paste

Colour

Passport

Photo of

the Passport

Holder

POLICE CLEARANCE CERTIFICATE FORMAT