PCC Reguest Form on london visa office

[Drooza]

Canadian High Commission Haut Commissariat du Canada
Immigration Section Section de l’immigration
38 Grosvenor Street 38, rue Grosvenor
London W1K 4AA Londres W1K 4AA
United Kingdom Royaume Uni

Website: www.canada.org.uk
Fax: 020 7258 6506

REQUEST FOR POLICE CERTIFICATES/CLEARANCES


SURNAME:



To Police or Relevant Authorities:

The person who has completed the authorisation form below is applying for admission to Canada as a permanent resident. To
meet Canadian immigration requirements, each member of his/her family aged 18 years and over requires an original Police
Certificate/Clearance of no criminal conviction.

The High Commission has issued this letter to assist the applicant to apply for clearance. We request that the certificates be
provided to the bearer of this letter, who will then forward them to the High Commission.

The UK police do not issue police clearances. Applicants in the UK apply to the Metropolitan Police Service under the “subject
access provisions of the Data Protection Act 1998" for information on their person.

Thank you for your co-operation.
The High Commission

TO BE COMPLETED BY APPLICANT

AUTHORISATION BY VISA APPLICANT
FOR RELEASE OF POLICE AND COURT RECORDS


I hereby authorise the Police or Relevant Authorities in ________________________________(name country) to disclose any
details of previous criminal convictions to the Canadian High Commission, London, England, for visa purposes only.

SURNAME:
GIVEN NAMES:
MAIDEN OR OTHER SURNAME(S) USED:
NAME IN ORIGINAL SCRIPT (i.e. Arabic, Chinese, etc.):
DATE & PLACE OF BIRTH: SEX: NATIONALITY:
ALL ADDRESSES WHILE RESIDENT
DATES: HOME ADDRESS:

SIGNATURE OF APPLICANT: __________________________________________ DATE: __________________ polcert.doc 09/05

 

[shibuya]

Good one Drooza. God Bless u and may ur goals be fulfilled. All the best for ur IELTS EXAMS.