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Police Clearance Application Form

To
Superintendent of Police
Lakshmipur

Subject: Application for Police Clearance Certificate

I, ISTIYAK AHMMED, hereby submit an application for police clearance certificate for the purpose of going abroad
for visit or permanent residence. The details of my particulars are provided below:

Personal Detail Ref No: 16HRY8L


Applicants Name : ISTIYAK AHMMED Apply Date: 20-JAN-24
Father's / Spouse Name : MD BAHAR UDDIN
Mother's Name : YEASMIN AKTER
Date of Birth : 09-SEP-02
Salutation : Mr.
Email :
National ID :
Mobile NO. : 01759913899
Passport NO. : A00729515
Issuing Country : Bangladesh
Issue Date : 12-SEP-21
Issue Place : Lakshmipur
Expire Date : 11-SEP-31
Verification Thana : Raipur

Present Address Permanent Address


Vill/Area : Bamni Vill/Area : Bamni
Post office : Ulfat Nagar Post office : Ulfat Nagar
Road-House/Flat : Ward No- 04- Road-House/Flat : Ward No- 04-
District : Lakshmipur District : Lakshmipur
Upazilla/P.S : Raipur Upazilla/P.S : Raipur
Post Code : 3711 Post Code : 3711

Delivery From: SP Office, Lakshmipur

Attached Documents
Passport Scan Copy Download
Ward Councillor Certificate Download
Chalan Copy Download
National ID Scan Copy Download

আপনার আবেদনের সর্বশেষ অবস্থা জানতে আবেদনে প্রদত্ত মোবাইলের মধ্যমে এসএমএস করুন PCC S 16HRY8L লিখে এবং পাঠিয়ে দিন 26969 নম্বরে (এখানে 16HRY8L আবেদনের রেফারেন্স
নং)। ফিরতি এসএমএস এ পেয়ে যাবেন সর্বশেষ স্ট্যাটাস

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