HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) (Authorised English Translation) HARYANA GOVERNMENT HOME DEPARTMENT NOTIFICATION The 31 st August, 2009. No. S.O. 83/C.A. 29/2005/S.25/2009.-- In exercise of the powers conferred by sub-section (1) read with sub-section (2) of section 25 of the Private Security Agencies( Regulation) Act, 2005(Central Act 29 of 2005), the Governor of Haryana hereby makes the following rules regulating the grant or renewal of license to a private security agency, namely :- Short title. 1. These rules may be called the Haryana Private Security Agencies Rules, 2009. Definitions. 2. (1) In these rules, unless the context otherwise requires;
(a) “Act” means the Private Security Agencies (Regulation) Act, 2005(Central Act 29 of 2005);
(b) “Agency” means a Private Security Agency;
(c) “Form” means a form appended to these Rules;
(d) “recognized institute” means any police or paramilitary training institution or such HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) other training institution, as approved by the Controlling Authority.
(2) Words and expressions not defined in these rules but defined in the Act, shall have the same meanings respectively assigned to them in the Act. Controlling 3. Authority.
Section 3
(1) The Additional Director General of Police, Law and Order, Haryana Police shall be designated as the Controlling Authority.
(2) The Controlling Authority shall be responsible for maintaining a website where all relevant information namely, the Act, rules, procedures, forms, circulars, notices for the general public shall be available both in Hindi as well as English, in order to do away with the need for personal visit.
(3) Every Agency shall designate an authorized representative and intimate the same to the Controlling Authority. Correspondence with the Agency shall be made, as far as possible, by electronic means through its authorized representative. The submission of application HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) forms, verification requests along with related documents, forms, fees etc. may also be made online. Verification 4. of antecedents of applicant.
Section 10
(1) An application for grant or renewal of licence under sections 7 or 8 shall be made by the applicant in Form V to the Controlling Authority along with information in Form I for verification of his antecedents. If the applicant is a company, a firm or an association of persons, the application shall be accompanied with Form I for every such applicant.
(2) On receipt of such application, the Controlling Authority shall make, or cause to be made, such enquiries, as it considers necessary to verify the contents of the application and the particulars of the applicants.
(3) The District Superintendent of Police or the Commissioner of Police, as the case may be, in addition to the causing of verification of antecedents of every individual in whose name the antecedent form is filled up, shall also furnish the following information-
(i) whether the applicant or the company HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) operated any private security agency earlier, either individually or in partnership with others and if so, the details thereof ; and
(ii) whether the applicant possesses any special qualification or skill, which may facilitate his operations of Private Security Agency. Verification 5. of character and antecedents of private security guards.
(1) No person shall be employed or engaged as a security guard unless the Agency has satisfied itself about the character and antecedents of such person in any one or more of the following manners, namely:-
(a) by verifying the character and antecedents of the person by itself;
(b) by relying upon the character and antecedent verification certificate produced by the person:
Provided that the character and antecedent certificate is valid and the Agency does not have any adverse report regarding the person’s character and antecedents from any HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) other source; or
(c) by relying on the report received from the police signed under the authority of the District Superintendent of Police.
(2) The person desirous of getting employed or engaged as security guard or supervisor shall submit information in Form II to the Agency. If the person has stayed in more than one district during the last five years, one copy per district shall be submitted.
(3) The Agency shall cause an inquiry into the correctness of the particulars filled in either by itself or by sending the Form II to the respective District Superintendent of Police.
(4) Where the Agency decides to verify the character and antecedents through the police, the police officer entrusted with the task of such verification shall visit the locality, where the person claims to have resided or is residing, and ascertain his identity and general reputation. Police records shall be consulted before preparing the HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) character and antecedents verification report. Criminal history of the person, if any, shall be specifically highlighted:
Provided that if a person has submitted copy of a reliable proof of identity, like a passport or any other identity document, as may be specified by the Controlling Authority in this regard from time to time, visit to the locality shall be dispensed with.
(5) For availing services of the police for character and antecedents verification, the Agency shall submit Form II of the person along with a fee of Rs. 500/- per candidate. The fee may be paid in cash, cheque, banker’s cheque or by electronic transfer.
(6) In case the Agency decides to verify the character and antecedents of the person by itself, it shall mandatorily consult the Police records/crime criminal database to ascertain the criminal history. For this purpose, the Agency shall submit a request to the concerned District Superintendent of Police along with information furnished HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) by the applicant in Form II along with a fee of Rs. 200/- per applicant. The police shall furnish the aforesaid report on the basis of police records only.
(7) The police authorities shall ensure that character and antecedent verification report and the report of verification of criminal history of the person for the purpose of sub rule (6), are issued within thirty days and ten days respectively of the receipt of the request failing which it shall be presumed that they have nothing adverse to report.
(8) The contents of the report of the police regarding character and antecedents of a person shall be kept confidential at all times.
(9) The character and antecedents verification report once issued, shall remain valid for a period of five years.
(10) On the basis of police verification or on the basis of their own verification, the Agency shall issue a character certificate in Form III. This certificate shall not be taken back by such Agency even if the person ceases to be the employee of that Agency. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Security 6. training.
Section 9
(1) Training shall be imparted to the security guards on the following subjects, namely:-
(a) conduct in public and correct wearing of uniform;
(b) physical fitness ;
(c) physical security, security of the assets, security of the buildings/apartments, personnel security, household security;
(d) fire fighting;
(e) examining identification papers including identity card, passport and smart cards;
(f) should be able to read and understand English alphabets and Arabic numerals as normally encountered at the time of identification of documents, arms licenses, travel documents and security inspection sheets;
(g) identification of improvised explosive devices;
(h) first aid; HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
(i) crisis response and disaster management;
(j) defensive driving (compulsory for drivers of armored vehicle and optional for others);
(k) handling and operation of non prohibited weapons and firearms (optional);
(l) rudimentary knowledge of The Indian Penal Code, 1860(45 of 1860), relating to right to private defense, procedure for lodging first information report in police station as mentioned in Code of Criminal Procedure, 1973;
(m) identification of different types of arms in use in public and police;
(n) use of security equipment and devices like security alarms and screening equipments ; and
(o) leadership and management (for supervisory staff only).
(2) The duration of the training for security guards shall be a minimum of hundred hours of classroom instruction HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) and sixty hours of field training spread over atleast twenty working days in a recognised institute. Ex-servicemen and former police personnel shall however be required to attend only a condensed course of minimum forty hours of classroom instructions and sixteen hours of field training spread over atleast seven working days.
(3) First level and second level supervisors concerned with the management of security services rendered by the Agency, shall also be imparted training for a period not less than three months, minimum six hours every day, from a recognized institute. For the persons having experience of defence, paramilitary or police service, a condensed course of six weeks duration shall suffice. In addition to the subjects for the training of security guards, they shall also be imparted training in criminal law, police working, leadership and managerial skills.
(4) Every security guard and supervisor concerned with the management of security services rendered by the Agency shall have to successfully undergo the training. On HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) completion of training, each successful trainee shall be granted a training certificate in Form IV by the recognized institute.
(5) Unsuccessful candidates shall not be assigned to security duty until they successfully complete the training.
(6) All Agencies shall submit a list of successful trainees to the Controlling Authority.
(7) The Controlling Authority shall lay down norms and the procedure for grant of recognition to training institutions, both public and private, for the purpose of imparting training to private security guards and supervisors in accordance with these rules. Standard of 7. physical fitness.
(1) No person shall be eligible for being engaged or employed as security guard or supervisor concerned with the management of security services, unless he fulfills the following standards of physical fitness:-
(i) (a) Height: Men -160 cms Women -150 cms
(b) Weight: According to standard table of height and weight.
(c) Chest: 80 cms with an expansion of 4 cms (for female no minimum requirement for HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) chest measurement).
(ii) Eye sight: far sight vision 6/6; near vision 0.6/0.6 with or without correction; free from color blindness; should be able to identify and distinguish color display, security equipments and read and understand display in English alphabets and Arabic numerals.
(iii) Free from knock knee and flat foot and should be able to run one kilometer in six minutes (Persons above forty five years of age shall get relaxation of one minute).
(iv) Hearing: free from defect and should be able to hear and respond to the spoken voice and the alarms generated by security equipments.
(v) The candidate shall have dexterity and strength to perform searches, handle objects and use force for restraining the individuals in case of need.
(2) A candidate shall be free from evidence of any contagious or infectious disease which is likely to be HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) aggravated by service or is likely to render him unfit for service or endanger the health of the public.
(3) The Agency shall ensure that every security guard working for it undergoes a medical examination after every twelve months from his last such examination, so as to ensure the continued maintenance of physical standard as specified for the entry level. Supervisors. 8. section 9
(1) There shall be one supervisor to supervise the work of not more than fifteen private security guards.
(2) In case the private security guards are on security duty in different premises and it is not practical to supervise their work by one supervisor, the Agency shall depute such number of supervisors so that at least for every six private security guards there is one supervisor available for assistance, advice and supervision. Grant of 9. licence. section 7
(1) An application for the grant of a licence under section 7 shall be made to the Controlling Authority in Form V. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
(2) Every application referred to in sub- rule (1) shall be accompanied with such fee as stipulated in sub section (3) of section 7. Payment shall be made by cash, demand draft, bankers cheque or electronic transfer.
(3) Every application referred to in sub-rule (1) shall be
(i) either personally delivered, or
(ii) sent to the Controlling Authority by registered post, or,
(iii) submitted online, provided the same is digitally signed by the applicant.
(4) On receipt of the application referred to in sub-rule
(1), the Controlling Authority shall send an acknowledgement to the applicant, either manually or electronically, as the case may be. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
(5) The Controlling Authority, after receiving the application under sub-rule (1) shall grant a licence to the Agency in Form VI after completing all the formalities and satisfying itself about the suitability of the applicant and also the need for granting the licence for the area of operation applied for:
Provided that no licence shall be issued without a no objection certificate from the District Superintendent of Police or the Commissioner of Police, as the case may be, of the district where the Agency has its principal place of business. For this purpose the Controlling Authority shall send a copy of the application for license along with its enclosures to the concerned district.
(6) The Controlling Authority either by itself or through its officers may verify the training and skills imparted to the private security guards and supervisors of any private security agency.
(7) The Controlling Authority may review the continuation or grant of licence of such HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Agency which may not have adhered to the condition of ensuring the required training. Conditions 10. for grant of licence. section 6
(1) The licencee shall inform the Controlling Authority regarding any change of persons forming the Agency or their address within thirty days of such change.
(2) The licencee shall intimate the Controlling Authority about any criminal case registered against a person forming the Agency or against a private security guard or supervisor engaged by the Agency within ten days of his knowledge of registration of FIR. A copy of such communication shall also be sent to the officer in charge of the police station where the said person resides.
(3) Every licencee shall abide by the requirements of physical standards for private security guards and supervisors and their training as prescribed in there rules as the condition on which the licence is granted. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
(4) Save as provided in these rules, the fees paid for the grant of licence shall be non-refundable. Renewal of 11. Licence. section 8
(1) An application shall be made to the Controlling Authority for renewal of the licence under section 8 in Form V.
(2) The fee for renewal of the licence shall be the same as for the grant thereof. Conditions 12. for renewal of licence. section 8 The licence shall be renewed subject to the following conditions, namely:-
(i) the applicant continues to maintain his principal place of business in the jurisdiction of the Controlling Authority;
(ii) the applicant continues to ensure the availability of the stipulated training for private security guards and supervisors;
(iii) the applicant continues to adhere to the license conditions;
(iv) the Controlling Authority has obtained a no objection certificate from the District HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Superintendent of Police or the Commissioner of Police, as the case may be, of the district where the Agency has its principal place of business. Appeal 13. section 14 An appeal preferred under section 14 shall be in Form VII alongwith a fee of Rs. 2000/-, signed by the appellant or his authorized representative and may be presented in person or by registered post to the State Government. Register 14. section 15 The register under section 15 shall be maintained by the Agency in Form VIII. Photo 15. identity card. section 17
(1) Every private security guard shall be issued a photo identity card under section 17 by the Agency in Form IX.
(2) The photo identity card shall have sufficient security features.
(3) The photo identity card issued shall be maintained upto date and any change in the particulars shall be entered therein.
(4) The photo identity card shall be returned to the Agency when the private security guard is no longer HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) engaged or employed by it.
(5) Any loss or theft of photo identity card shall immediately be brought to the notice of the Agency. Other 16. conditions
(1) Every private security guard while on duty shall put on,-
(a) an arm badge distinguishing the Agency;
(b) shoulder or chest badge to indicate his position in the organization;
(c) whistle attached to the cord and to be kept in the left pocket;
(d) shoes with eyelet and laces;
(e) a headgear which may also carry the distinguishing mark of the Agency; and
(f) photo identity card on the outer most garment above waist level on his person in a conspicuous manner.
(2) The clothes worn by the private security guard while on duty shall be such that they do not hamper with his efficiency. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
(3) Every private security guard shall carry a note book and a writing instrument with him. Form 1 (see rule 4) Form for verification of antecedents of applicant
1. Thumb impression of the applicant: (Please affix left Hand Thumb impression in case of Male and Right Hand Thumb Impression in case of Female)
2. Specimen Signature of the applicant:
(i) ……………………………
(ii) …………………………....
(iii) ………………………..….. Please fill all particulars in BLOCK LETTERS. (CAUTION: Please furnish correct information. Suppression of any factual information shall render the candidate unsuitable for grant of license.)
3. Payment of fee details: Fee Amount ………………… Mode of Payment …………………………… Passport size recent photograph attested by class -1 Gazetted Officer HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Name of Bank (if any) ……………… No. & date …………………………. Personal Particulars :-
1. Last name: …………………………………………….……….
2. First name: …………………………………………….…..……
3. If the applicant has changed his name, please indicate all previous names in full: ……………………………………………………… ……………………………………………….………
4. Sex (male/female): ………………………….…….
5. Date of birth: ……………… Age: …………………………
6. Place of Birth: …………………..………………. District , State & Country: …………………………………..
7. Visible Distinguishing Mark: ………………………………….
8. Telephone No (with STD code): ………………………………….
9. FAX No: …………………………………
10. Cell Phone No: …………………………………
11. Particulars of family Members: Relation First name Last name Present Address Father Mother Spouse (if any) HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Legal Guardian (if any)
12. Present Residential Address: District: State: PIN Code:
13. Please give date since residing at the above-mentioned address: ……………..
14. If the applicant has not resided at the address given at column (12) above continuously for the last five year, particulars of earlier addresses: S. No. Address From To Please furnish additional copies of this form for each additional place of stay during the last five year. Forms may be photocopied if required, but photograph and signature are required to be affixed in original on each copy.
15. Permanent Address: District: State: PIN Code: HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
16. In case of stay abroad, particulars of places where the applicant has resided for more than 6 months after attaining the age of twenty-one years: S. No. Address From To
17. Other Details:
(a) Educational Qualifications: S. No. Qualification Name of the Institution Board/University Year %age Marks
(b) Work experience: S. No. Name and address of employer Contact Telephone No. Position held From To
(c) Reason for leaving last employment: ………………………………….
18. Have you ever operated any Private Security Agency: ……………………
19. If yes, give details: S. No. Name & address Since when HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
20. Are you a citizen of India? Yes/No If yes, whether by Descent/Registration /Naturalization (Please tick the correct option)
21. In case you have ever possessed citizenship of any other country, give names: …………………………………………………………………………………
22. Have you at any time been convicted by a court in India for any criminal offence? If yes, give details (Case number & year, Police Station, Name of the court and offence): ………………………………………………………………………………… ………………………………………………………………………………… (Please attach copy of the judgement in each case)
23. Are any criminal proceedings pending against you before a court in India? If yes, give details (Police Station, Case number & year, Name of the court and offence): …………………………………………………………………… ………………………………………………………………………………… Date ______________ (Signature/T.I of applicant) Place _____________ HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
24. Enclosures:
1. …………………………………..
2. …………………………………..
3. …………………………………..
4. ………………………………….. Declaration: The Information given by me in this from and enclosures is true and I am solely responsible for its accuracy. (Signature/T.I of applicant) (*Please affix left Hand Thumb impression in case of Male and Right Hand Thumb Impression in case of Female) For office use only Form number Name of the police station where sent for police verification Date of Despatch Remarks HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM II (see rule 5) Form for verification of character and antecedents for Private Security Guard
1. Thumb impression of the applicant: (Please affix left Hand Thumb impression in case of Male and Right Hand Thumb Impression in case of Female)
2. Specimen Signature of the applicant:
(i) ……………………………
(ii) …………………………....
(iii) ………………………..….. Please fill all particulars in BLOCK LETTERS. (CAUTION: Please furnish correct information. Suppression of any factual information will render the candidate unsuitable for grant of license.)
3. Payment of fee details: Fee Amount ………………… Mode of Payment …………………………… Name of Bank (if any) ……………… No. & date …………………………. Personal Particulars :-
4. Last name: …………………………………………….………. Passport size recent photograph attested by class -1 Gazetted Officer HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
5. First name: …………………………………………….…..……
6. If the applicant has changed his name, please indicate all previous names in full: ………………………………………………….……… ………………………………………………….………
7. Sex (male/female): …………………………….…….
8. Date of birth: ……………… Age: ………………………….
9. Place of Birth: …………………..………………. District , State & Country: …………………………………..
10. Visible Distinguishing Mark: …………………………….…….
11. Height: …………Weight: …………Chest without expansion………… with expansion ………………... (applicable in case of male applicants only)
12. Telephone No (with STD code): …………………………………. Mobile Phone No: …………………………………
13. (i) Passport No: …………. Date: ………… Issued at: ………..
(ii) Voter ID Card No: ………………. Issued by: ……………….
(iii) Name/Particulars of any other ID proof: …………………….. Number:…………. Date: ……… Issuing authority: ……….
14. Particulars of family Members: Relation First name Last name Present Address Father Mother Spouse (if any) HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Legal Guardian (if any)
15. Present Residential Address: District: State: PIN Code:
16. Please give date since residing at the above-mentioned address: ……………..
17. If the applicant has not resided at the address given at column (12) above continuously for the last five year, particulars of earlier addresses: S. No. Address From To Please furnish additional copies of this form for each additional place of stay during the last five year. Forms may be photocopied if required, but photograph and signature are required to be affixed in original on each copy.
18. Permanent Address: HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) District: State: PIN Code:
19. In case of stay in a foreign country, particulars of places where the applicant has resided for more than 6 months after attaining the age of twenty-one years: S. No. Address From To
20. Other Details:
(a) Educational Qualifications: S. No. Qualification Name of the Institution Board/University Year %age Marks
(b) Work experience: S. No. Name and address of employer Contact Telephone No. Position held From To HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
(c) Reason for leaving last employment: ………………………………….
21. Do you have a valid Character and antecedents certificate in Form III? Yes/No If yes, please attach a copy.
22. Are you a citizen of India? Yes/No If yes, whether by Descent/Registration /Naturalization (Please tick the correct option)
23. In case you have ever possessed citizenship of any other country, give names: …………………………………………………………………………………
24. Have you at any time been convicted by a court in India for any criminal offence? If yes, give details (Case number & year, Police Station, Name of the court and offence): ………………………………………………………………………………… ………………………………………………………………………………… (Please attach copy of the judgement in each case)
25. Are any criminal proceedings pending against you before a court in India? If yes, give details (Police Station, Case number & year, Name of the court and offence): …………………………………………………………………… ………………………………………………………………………………….. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
26. Has any court issued a warrant or summons for appearance or warrant for arrest or an order prohibiting your departure from India? If so give name of the Court, case number and other details. ………………………………………………………………………………… ………………………………………………………………………….
27. Declaration: The information given by me in this form and enclosure is true and I am solely responsible for accuracy. (Signature/T.I of applicant) (* Left Hand Thumb Impression if Male and Right Hand Thumb Impression if Female) Date…………………. Place………………….
28. Particulars of person to be intimated in the event of death or accident: Name………………………………………………………………………… Address…………………………………………………………………….. Mobile/Tel. No……………………………………………………………
29. Enclosures:
1. ……………………………….. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
2. ………………………………..
3. ………………………………..
4. ……………………………….. (Signature/T.I of applicant) (*Please affix left Hand Thumb impression in case of Male and Right Hand Thumb Impression in case of Female) For office use only Form number Name of the police station where sent for police verification Date of Dispatch Remarks HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM III [See rule 5(10)] CHARACTER AND ANTECEDENT CERTIFICATE This is to certify that Sh/Smt/Km …………………………………………………….. Son/Daughter of ………………………………………………………………………. whose particulars are given below has good moral character and reputation and that the applicant has been staying at the following address continuously for the last …………. :- Date of Birth………………………………………………….... Place of Birth……………………………………………….….. Educational Qualification………………………………….…… Profession:………………………………………………….…… Present Address…………………………………………………. Permanent Address……………………………………………… Issuing Authority Signature: Name & Designation: …………………… Address/Tel No: …………………… Date of Issue: ……………………. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM IV [See rule 6(4)] Training Certificate Serial number: ……………… Name of the Training Institution: ……………………………………………... Address of the Training Institution: ……………………………………………. ……………………………………………. License No: …………………… Certified that Sh/Smt/Km…………………………………………………………… Son/daughter of …………………………………………………………………….. Resident of………………………………………………………………………….. has completed the prescribed training for the engagement or employment as a Private Security Guard from……………… To ………………… His signature is attested below: Signature of the Certificate Holder: …………………………………… Signature of issuing authority Designation: Place of Issue…………………. Date of Issue………………….. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM V (See Rule 9 and 11) APPLICATION FOR LICENCE/RENEWAL To The Controlling Authority ………………………….. …………………………. The undersigned hereby applies for obtaining a licence to run the business of Private Security Agency:-
1. Name of the Applicant: .……………………………………......
2. Address:…………………………………………………………… …………………………………………………………………… …………………………………………………………………….
3. Telephone No: ……………………Fax No: ……………. Email address: …………………...
4. Address where the applicant has or desires to have his principal place of business: …………………………………………………………. ……………………………………………………………………….
5. Name address and contact details of the authorized representative of the applicant for the purpose of correspondence with the Controlling Authority……………………………………………………………… ………………………………………………………………………… HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
6. Names and Addresses of Proprietor, Partners, Shareholders, Managing Director, Directors and important office bearers of the Agency: S No. Name Parentage Address Nationality (Please attach separate sheet if required. Also furnish personal particulars of each of the persons above in Form I separately for verification of antecedents.)
7. Particulars of facilities available………………………… (Please attach separate sheet if required)
8. Qualifications of staff engaged for imparting instruction; Name …………………………………………………… Age…………………………………………………….. Designation……………………………………………. (Please attach separate sheets if required)
9. Equipment available for providing Security services: (Please attach separate sheet if required)
10. Particulars of uniform (color, badge etc): (Please attach separate sheet if required)
11. Does the applicant have licence to operate private security agency in any other State? ……… (If yes, enclose copy of the licence) HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA)
12. Does the applicant intend to operate in more than one district/ if so name of the Districts 1………....….2…………..…3………..……4……..…..….5……..…… (Please attach separate sheet if required)
13. Does the applicant intend to operate in the entire state:
14. Does the Agency possess training facility of its own or will it get it on outsourcing basis? …………………………………………………….. The name and address of each such training facilities should be furnished in a separate sheet, if required).
15. Payment of fee details: Amount: …………… Mode of Payment: ………………… Name of Bank (if any)……………… No. & date: …………. Signature : Name of the applicant : Address of the applicant :………….. Date: Place: Enclosures:
1. Copy of current Income tax clearance certificate.
2. Affidavit as prescribed in section 7 (2) of the Act.
3. ………………………..
4. ……………………….. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM VI (See rule 11) Licence to engage in the business of Private Security Agency
1. Serial No…………………………..
2. Date……………………………….
3. Shri/Smt/Km………………………………….. (Name of the applicant) son/daughter of …………………………………………………………….. R/O……………………………………………………………………………... .…………………………………………………………….…….(Full Address) …………………..is hereby granted the licence by the Controlling Officer for the State of ……………………………………………………. to run the business of Private Security Agency in the District (s)/State of (Strike off inapplicable words)……………………………………….…………………… …………………………………………………………………..…………….. ...…………………………………………………………..........…………….. with office at…………………………… Place of issue……………………….….. Date of Issue…………………………… This Licence is valid upto……………… Signature Name of Controlling Authority Designation: Officials Address: HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) RENEWAL (See rule-14) Date of Renewal Date of Expiry
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4. Signature Name of granting Authority Designation Officials Address HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM VII (see rule 13) Form for Appeal To The Financial Commissioner and Principal Secretary to Government Haryana, Home Department, Chandigarh. Sir/Madam, The undersigned hereby prefers an appeal under section 14 of the Private Security Agencies (Regulation) Act, 2005 as per the following details:- Shri/Smt/Km…………………………………..(Name of the applicant) son/daughter of ………………………………………………………… R/O ………….……….. ………………………………………………………………………..(Full Address) Controlling Authority ……………………………………………………….. Against Order No & Date: ………………………………….………………….. In the matter of: ………………………………………………………… (Enclose copy of the impugned order) Ground(s) of appeal: ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… (Enclose separate sheet if required) Lists of enclosures: 1……………………………………… 2………………………………………. 3……………………………………… 4…………………………………….. Signature Name of the appellant: ……………….. . Date…………………. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) Place…………………. HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM VIII (See rule 14) Register of particulars (Part-I Management Details) S. No. Name Father’s Name Position held Present Address & Phone No. Permanent Address Nationality Date of Joining/leaving the Agency (Part-II Private Security Guards and Supervisors) S No. Name Father’s Name Rank /Post Present Address & Phone No. Date of Joining/ leaving the Agency Permanent Address Photograph Badge No. Salary with date (PART-III Customer details) (PART-IV Duty Roster) S. No. Name of Private Security Guard and Supervisor Address of the place of duty Whether provided any arm/ communication equipment Date and time of commencement of duty Date and time of end of duty S. No. Name of Customer, Address & Phone No. Address of the place where Security is provided Number and Rank of Security Guard Provided Date of Commencement of Service Date of Discontinuation of service HARYANA GOVT. GAZ., SEPT. 1, 2009 (BHDR. 10, 1931 SAKA) FORM IX (see rule 15) (Name and logo of the Private Security Agency)
1. Name …………………………………
2. Rank……………………………
3. ID No…………………………………
4. Blood Group ………………………..
5. Valid upto……………………………
6. Specimen signature: ……………….. Signature of the Date of Issue: Issuing Authority with Office seal (Additional information namely, contact details etc of the Agency may be provided on the back side) ___________________________________________________ KRISHNA MOHAN, Financial Commissioner and Principal Secretary to Governments, Haryana, Home Department. Photograph of the holder duly attested by the issuing authority