EAP-II

Embassy of India
Riyadh
Please affix a
Application for Miscellaneous Services recent Photograph
3.5 cm X 4 cm
Service Required:

Indian Police Clearance Certificate (PCC) for ______________________________

(please write name of country)
NOC/Endorsement letter for SAUDI PCC

NRI Certificate

Duplicate Birth Certificate

Certificate as per entries in Passport

Surrender of Indian Passport / Renunciation of Indian nationality

Any other – Please specify with an explanation letter : _______________________________________

1. Full Name (as per passport) :

2. Name of Father :

3. Name of Mother :

4. Name of Spouse and Nationality :

5. Date of Birth :

6. Place of Birth :

7. Address in India :

Tel No. in India :

8. Address in KSA :

Tel No./Mobile No. in KSA :

9. Details of current passport

Passport No. : Date of Issue :

Place of Issue : Valid Until :

I solemnly affirm that I owe allegiance to the sovereignty and integrity of India and that
the information given above is correct and nothing has been concealed and I am aware that it is
an offence under the Passports Act, 1967 to knowingly furnish false information or suppress
material information.

Place: ___________________________________
Date : Signature/Thumb Impression of Applicant