Criminal Disclosure Declaration

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CRIMINAL DISCLOSURE DECLARATION

NAME : ___________________________________________________________________

ADDRESS : _______________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Have you ever been accused, charged and /or convicted for any criminal offence by a court of law
in India or in a foreign Country?

YES NO

____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________
SIGNATURE: _________________

PLACE: _____________________ DATE: ______________________________


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