Z.R .·P.--Rili.Vf- 5-5-RJ. FORM 137.
FOR OFFICE USE ONLY
Application for Police Certificate Serial No. ..... .. ... ................ ...... .. ....... . Date received ....... ...... ... ... ... , .. .... .... . , ....
(To be completed in block letters) C.lD. H.Q. Ref . ... ...... ..... .. .... .... ......... C.B·/C.B.D . ... ........... ... .. ... ................ ....
Surname of applicant .. . ... ... .. . .. .
Christian names '" ... .. . ... .. . ...
Maiden name ... .. . .. . ... ... .. . .. .
Previous married names .. . .. , ... ... -- -_.
..
Date of birth .. . ... .. . ... .. . .. . ...-_. Town of birth '" ... .. . ... ." ... ... .. _- - -Country of birth ... ... ... ... .. . .. ,
-
-
Date of first entry into Zimbabwe .. . ...
Place of first entry into Zimbabwe
Present residential address .. , . ..
... ...
.. . .. . - -- - - - - -_.. • _.
Present business address .. . .. . ... ... -
-Why are you applying for a Police Certi
-_ .-.-- - _ ._--- _._------'ficate? ... .. , ... ... .. . .. . ... . ..
- -.
Which country is your intended destination? What will be your address thereat? .. . ...
What is your proposed date of departure? ...
To which address should the completed Certificate be sent? .. . " . ... .. . ...
Have you been convicted in Zimbabwe of ..__.__ .__._- -... . _---------- ------.'--
.,0'aI'.y offence? If so give details . ...
IMPORTANT: Please read and comply with the instructions on the back of this form before signing.
$4 Zimbabwe Revenue
Stamp to be affixed here
Signature of Applicant
Date .... .. .. . ... . .. . .... .. .. .. .. .. . . .. . . ..
FINGER-PRINT FORM (This form must be completed In BLOCK LETTERS)
Name of person flnger-prinled - ________________~-------------------___
Allaa ----------------------- Sex Race ~---______
Regiliered Number___________~_'___ OffIce of ISlue Dale of I.slue ---_______
Reaaon for search for use by Central Criminal Bureau OffIce of origin of prlnta -
FuU Mldre.. 01 olftce to which \hIt form I. to be returned C.I.D H.Q. Ref.
Bureau Docket NumberWHERE FINGER-PRINTS ARE NOT SHOWN BELOW, INDICATE IN Bureau NumberAPPROPRIATE SPACE, WHETHER - "MISSINGR, "INJURED", ETC. WITH DATE OF AMPUTATION OR INJURY.
See revenae of form for addresa 10 which finger prlnla are to be aant and for nolaa on finger-prlntlng.
.. RIGHT HAND
Righi thumb Right forefinger Right middle finger
_
Right ring finger ..
Right little finger
- Fold
LEFT HAND
Left thumb Left foreflnger Left middle finger Left ring finger Left little finger
- Fold
LEFT HAND RIGHT HAND
Impressions of all LEFT fingers laken simultaneously Impressions of all RIGHT fingers taken slmultaneoualy
- Fold - _.." . _. .....
Flnger"9f1nta taken by Dille
For C.C.B. use only Impress almuHaneoua/y
Cluallled by
LEFT THUMB RIGHT THUMB _.. . .. .
Cheeked by - .
Searched by
N.I.C. number -------- - - -------- District -
District of origin --_ _ _____ ____~-_--------- Country of orlgIRR--_ _ ___________~
Date and place of birth ------------~~-----------------------------Helght------
Passport No. and country of origin _ _________________ ______ ---UDate of Issue ----_______
Signature of person whose prints are on the front of ,this form
Remarks
ADDRESSES OF FINGER-PRINT BUREAUX: (1) OffIcer Commanding, (2)
C.C.B. The ~~'strar,A.F.I:S.
C.I.D. Headquarter. P.O. Box 1399, P.O. Box 8125, Causeway Bulawayo Harare
Noles on how 10 lake clear finger·prlnr. "
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A BLURRED FINGER-PRINT HAS NO VALUE. ALL PRINTS MUST BE AS CLEAR AS POSSIBLE -, " ',,' (a) ALWAYS ent9f partlculara 01 person on linger-print lorm IMMEDIATELY AFTE~ taking his linger-prints. DO NOT take other prints until you haVe done so. :' (b) ALWAYS use the correct Ink supplied. DO NOT uae ordinary Ink or the Ink on an Inking pad lor rubber stamps. ' (c) Fingers must be clean and dry. /I necessary, person having prlnta taken must waah hands. (d) It lingers are badly worn, make smooth by using pumice stone, Remove 011 or tar with benzine. .. .. (E') USE' a clean pad with no dust or old Ink on It Put Inkon evenly - no lumps or blobs. Do not use too much Ink (this Is a common 131,111).
. _. ~ - - ~ ~~ '_I, - - ~ ~ ..... hl rl ...... . ·1"\ t" H,t) fi re' i(".i nt of finof'r,
