HIGH COMMISSION OF INDIA, LILONGWE
Paste your
Phone No.01755337, Fax No.01755346
unsigned recently
e-mail :
cons.malawi@mea.gov.in
taken colour
Website:
photograph
POLICE CLEARANCE CERTIFICATE APPLICATION FORM
(showing both the
ears)
Signature (as given in passport) OR Thumb
impression
Please fill this form in CAPITAL LETTERS. Furnishing of incorrect information/suppression of information would lead to
rejection of the application and would attract penal provisions as prescribed under the Passports Act, 1967. Please furnish your
original documents at the time of submission of the form. Please leave a blank column in between two words
Passport Number
Date of Issue
Place of Issue
Date of Expiry
Country for which PCC is required
1. Applicant's given name (given name means First Name followed by Middle Name (if any) (initials not allowed)
Surname
2.1 Father's given name (given name means First Name followed by Middle Name (if any) (initials not allowed)
Surname
2.2Mother's given name (given name means First Name followed by Middle Name (if any) (initials not allowed)
Surname
2.3 Spouse's given name (given name means First Name followed by Middle Name (if any) (initials not allowed)
Surname
3. Present Residential Address
Mobile Number
Telephone Number
E-Mail ID
4. Permanent Residential Address
Police Station