PROFORMA FOR ISSUE OF LOOK OUT CIRCULAR Affix here Recent Passport Size Photograph 1. PERSONAL PARTICULARS a. FIRST NAME b. MIDDLE NAME c. SURNAME d ALIAS (IF ANY) 2. SEX MALE FEMALE 3. FATHER'S NAME 4. PRESENT NATIONALITY 5. PLACE OF BIRTH 8. OCCUPATION 9. PHYSICAL DESCRIPTION a. COLOUR OF EYES BROWN BLACK GREEN BLUE b. COLOUR OF HAIR c. HEIGHT CMS FEET INCHES d. ANY OTHER DISTINGUISHING MARK OR PHYSICAL ATTRIBUTE 10. PASSPORT DETAILS a. PASSPORT NO. b. PLACE OF ISSUE c. COUNTRY OF ISSUE d. ISSUE ON Date Month Years e. VALID TILL Date Month Years 11. a. CRIMINAL CASE (SPECIFY FULL DETAILS) (i) FIR No. Date (ii) SECTION OF LAW _________________________ _________________________ _________________________ (iii) POLICE STATION (iv) DISTRICT (v) COUNTRY b. WANTED BY LAW COURT/JUDICIAL AUTHORITY (i) NAME OF THE COURT (ii) ORDER BY WHICH SUBJECT IS WANTED c. NAME OF ANY OTHER AGENCY ________________________ AUTHORING THE LOC ________________________ d. SPECIFY PERIOD OF RETENTION OF LOC (MONTHS) (Retention of LOC can not exceed 12 months/one year in terms of MHA order no. 25055/20/98 F-IV dated 27/12/2000. Requests for renewals are to be made by competent authority from time to time or on yearly basis). 12. ACTION EXPECTED FROM IMMIGRATION CHECK POINT a. INFORM ORIGINATOR OF ARRIVAL/DEPARTURE OF SUBJECT (BUT NO OTHER ACTION TO BE TAKEN) b. SEIZE TRAVEL DOCUMENT AND SEND TO ORIGINATOR c. PREVENT SUBJECT FROM ENTERING INDIA AND INFORM ORIGINATOR d. DETAIN AND HAND OVER INTERCEPTED PERSON TO LOCAL POLICE AND INFORM ORIGINATOR. 13. PARTICULARS OF THE ORIGINATOR a. NAME OF THE OFFICER b. DESIGNATION c. DEPARTMENT/AGENCY/COURT d. CONTACT TELEPHONE NUMBER (WITH STD CODES) OFFICE RESIDENCE MOBILE FAX E-MAIL IS ON HOLIDAY OR AFTER OFFICE HOURS. SIGNATURE OF THE ORIGINATOR. NAME______________________________ DESIGNATION_____________________
