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Station sent for police verification Fee Amount Rs.----------- Cash/D.D------------- Name of Bank---------- Date D.D No. -------------- Date of issue-------------Please read the instruction carefully before filling the form. Please fill in Block Letters (caution Please furnish correct information. Furnishing of incorrect information or suppression of any factual information in the form will render the candidate unsuitable for grant of license) 1. Name of applicant (Initials not allowed) La.

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