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Police Verification Form

Police verification form is used by the officers to verify the identity of certain person who may be accused or culprit. This form intends to confirm the reporting of particular person and hence verify the information needed to contact him/her again in future.  This is very popular type of verification forms and is being used by so many police stations around the US and rest of the world.

Here is a sample police verification form for you.

Person Name: _________________________________ Father Name: ______________________________Age________

Date of Birth____________ Place of Birth ______________Native Language__________ Social Security No______________

Temporary address _________________________________________________ State______________ ZIP ____________

Permanent address _________________________________________________ State_____________ ZIP _____________

Phone (Land Line) ____________________ Phone (mobile)_____________________Email __________________________

Marital status: _________________Wife/Husband Name ____________________ His/Her Contact No _________________


Occupation: _____________________________________ Job Title/ Business Position:_____________________________

Business/Work Place Address ___________________________________________________________________________

State: ______________________ ZIP_________________ Phone__________________Email________________________


Name of the Dependents (If any) : ________________________________________________________________________


Particulars of Your Criminal Record? (If any) _______________________________________________________________

Have you ever been forced to do some community service? ____________________________________________________

Name of two references:

1) _____________________________________

Permanent address _________________________________________________ State_____________ ZIP _____________

2) _____________________________________

Permanent address _________________________________________________ State_____________ ZIP _____________




I, hereby, declare that all the information provided here is true and that I understand the consequences of putting up any miss-leading or wrong information here.


_________________________                         ________________________

Signature of the person                                                     Date

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