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Certification
As per my belief and knowledge information mentioned above is truth and the applicant is known to me for ................... years. He has provided signature/ fingertips before me.

Residential address of the identifier: .............................................
Passport/ National Identity Card No: .............................................
Telephone Number (If available): ..................................................
Name and signature of the identifier:
Date: .................................
(Seal)
Police Verification Report
Police Verification Number: .............................................                         Date: ...................................
Verification of the information of the applicant:
Correct
Not correct

Reasons if it is not correct (Not citizen of Bangladesh/ punished/ case is ongoing/ address is not correct/ other reason): ..............................................................................................................................
.....................................................................................................................................
.....................................................................................................................................

Signature of the report issuer
(Police ID and seal)
Signature of the supervising officer
(Police ID and seal)
Signature of the duplicate report signature provider officer
(Police ID and seal)




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