THE LAKSHADWEEP GAZETTE EXTRAORDINARY

VOL. LVIII No. 43 TUESDAY, 25^th OCTOBER, 2022/3^rd KARTHIKA, 1944 (SAKA)

PRICE : 75 PAISE

THE LAKSHADWEEP PRIVATE SECURITY AGENCIES RULES, 2022

NOTIFICATION

F.No.02/01/2019-HC/2166 - In exercise of the powers conferred by section

25 of the Private Security Agencies (Regulation) Act, 2005 (Central Act, 29 of 2005)

and in supersession of the Lakshadweep Private Security Agencies Rules, 2016 except

as respects things done or omitted to be done before such supersession, the

Administrator, UT of Lakshadweep hereby makes the following rules, namely:-

Short title and commencement.— (1) These rules may be called the

Lakshadweep Private Security Agencies Rules, 2022.

(2) They shall come into force on the date of their publication in the Official

Gazette.

Definitions. - 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;

clause (b) of section 2 of the Act;

(d) ―Form‖ means, a Form appended to these rules;

(e) ―Licence‖ means a licence granted under the Act;

(f) words and expressions not defined in these rules but defined in the Act,

shall have the same meaning respectively assigned to them in the Act.

LAKSHADWEEP ADMINISTRATION

HOME DEPARTMENT

SECRETARIATE, KAVARATTI- 682555

Kavaratti, dated 20^th October, 2022

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Application for grant of licence. - (1) Every agency while making an

application in Form I to the Controlling Authority for the grant of licence shall also

enclose the Form II for verification of his antecedents.

(2) If the applicant is a company, a firm or an association of persons, the application in

Form I shall be accompanied by Form II for every proprietor or majority shareholder,

partner or director of the company, as if they were also the applicants. In addition, he

shall submit an Affidavit in Form III incorporating the details in relation to the

provisions contained in sub-section (2) of section 7 of the Act.

(3) On receipt of Form I, Form II, Form III, the Controlling Authority shall make such

inquiries, as it considers necessary to verify the contents of the application and the

particulars of the applicant.

(4) The Controlling Authority shall utilise electronic databases of crime and criminals

like the Crime and Criminal Tracking Networks and Systems (CCTNS), Interoperable

Criminal Justice System (ICJS) and also from the concerned Police Station for the

purpose of verification of antecedents of the applicant.

(5) Wherever any applicant’s antecedents have been verified in any other State earlier

and licence is granted, it shall not be necessary for the Controlling Authority to verify

the antecedents afresh provided that the licence for which antecedents are verified is

under period of validity.

(6) Form I shall be accompanied by a demand draft or banker’s cheque or electronic

evidence showing the payment of fees as prescribed under sub-section (3) of section 7

of the Act, payable to the Controlling Authority of the State concerned where the

application is being made.

(7) The application referred to in sub-rule (1) shall be either personally delivered to the

Controlling Authority or sent to him by registered post or through electronic means.

(8) On receipt of the application referred to in sub-rule (1), the Controlling Authority

shall after noting thereon the date of receipt by him of the application, grant an

electronic or digital acknowledgement to the applicant.

(9) The Controlling Authority, after receiving an application in Form I shall grant a

licence to the private security agency in Form IV after making such enquiry as it

considers necessary, and after compliance with the provisions of the Act:

Provided that if the private security agency has already obtained a licence from

the Controlling Authority of any other State then requirement of training of the

licensee shall not be necessary.

(10)

The Controlling Authority either by itself or through its officer or any other

means shall verify the premises of the private security agency at the address or

addresses provided by the agency.

(11)

The Controlling Authority shall cause a physical copy of the licence to be

delivered by post within fifteen days of issue to the principal office of the private

security agency in the State concerned as mentioned in the application for grant of

licence which the private security agency shall be bound to display at its place of

business.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

(12)

In case of rejection of the application for grant of licence, no order of refusal

shall be made unless,-

(a) the applicant has been given a reasonable opportunity of being heard; and

(b) the grounds on which licence is refused is mentioned in the order.

(13) The Controlling Authority shall pass an order on Form I within sixty days from

the date of receipt of it complete in all respects.

(14) Applications for grant/ renewal of licence to the agencies shall be received in

online mode only on the PSARA Portal’ and all the successful applicants after

issuance of PSARA license shall mandatorily provide all the desired information to the

Lakshadweep Administration from time to time through e-filing prior and subsequent

to the commencement of business.

Conditions for grant of licence.-(1) The licensee shall successfully undergo a

training relating to the private security as prescribed by the Controlling Authority

within the time frame fixed by it.

(2) The Controlling Authority shall frame the detailed training syllabus required for

training the licensee.

(3) The training shall be for a minimum period of six working days. The training shall

broadly include the following subjects, namely;-

(i) Present security scenario:

(a) VIP Security

(b) Internal Security

(ii) Role and Functioning of Private Security Agencies:

(a) Fire Fighting

(b) Disaster/ Emergency Management protocol

(d) Checking of various documents

(e) Information security

(f) Access Control

(g) Explosives, IEDs

(h) Anti Sabotage Checks (ASC)

(i) Security related equipments

(j) Communication Equipments

(k) Patrolling

(l) Post duties

(iii) Legal provisions:

(a) The Private Security Agencies (Regulation) Act, 2005 (Central Act29 of

2005) and its associated State Rules.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

(b) Relevant Labour Laws

(iv) Management of Security Agencies:

(a) Uniform

(b) Training of personnel of private security agencies

(d) Data Sharing Protocol

(v) Interface with public, Police and other departments:

(a) Interface with Public

(b) Liaison with police and other concerned Government Departments

(vi) Private Security Personnel – DO’s and DON’Ts (Conduct Rules)

(4) The licensee shall intimate the name, parentage, date of birth, permanent address,

address for correspondence and the principal profession of each person forming the

Agency within fifteen days of receipt of the licence to the Controlling Authority.

(5) The licensee shall inform the Controlling Authority regarding any change in the

address of persons forming the Agency or change of management within thirty days of

such change.

(6) The licensee shall immediately intimate to the Controlling Authority about any

criminal charge framed against the persons forming the Agency or against a private

security guard or supervisor engaged or employed by the Agency, in the course of

performance of duties as private security agency. A copy of such communication shall

also be sent to the officer in charge of the police station where the person charged

against resides.

(7) Every licensee shall abide by the requirements of physical standards for the private

security guards and their training as prescribed in these rules as the condition on which

the licence is granted.

(8) Save as provided in these rules, the fees paid for the grant of licence shall be non-

refundable.

(9) The licensee shall commence its activities within six months of obtaining the

licence.

(10) Commencement of activities shall include establishment of office premises and

engagement of supervisors as provided under sub-section (3) of section 9 of the Act

and in accordance with rule 10.

Renewal of licence.— (1) Every Agency shall apply to the Controlling

Authority for renewal of the licence in Form I along with Form II and Form III not less

than forty-five days before the date of expiry of the period of validity thereof and after

complying other conditions of section 8 of the Act.

(2) If the applicant is a company, a firm or an association of persons, the application in

Form I shall be accompanied by Form II for every proprietor or majority shareholder,

partner or director of the company, as if they were also the applicants.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

(3) The Controlling Authority shall verify the antecedents of the applicant in the same

manner as mentioned in sub-rule (4) of rule 3.

(4) The Controlling Authority, after receiving an application in Form I shall grant a

renewal of licence in Form IV after making such enquiry as it considers necessary and

after compliance with the provisions of the Act.

(5) In case of non-receipt of the application for renewal of licence within the period

mentioned in sub-rule (1), the agency shall be treated as un-licensed agency after the

expiry of licence.

(6) After expiry of period of applying for renewal of licence, the Agency may apply

for fresh licence as per section 7 of the Act.

(7) The fees chargeable for renewal of the licence shall be the same as for the grant of

licence as mentioned in sub-rule (6) of rule 3.

(8) Applications received after the period stipulated in sub-rule (1) and before the

expiry of licence shall not be processed for renewal of licence.

(9) The Controlling Authority shall pass an order on application for renewal of licence

in Form I within thirty days from the date of receipt of application complete in all

respects.

(10) The validity of renewed licence shall be counted from the date of expiry of the

previous licence and shall be up to a period of five years irrespective of its date of

renewal. In case the application is decided by the controlling authority after expiry of

the existing licence, the intervening period shall deem to be under valid licence.

(11) The Controlling Authority and the Private Security Agencies shall not be liable

for delays occurring by reason of circumstances beyond human control, including but

not limited to acts of civil or military authority, national emergencies, riot, acts of

God.

Conditions for renewal of licence.—The renewal of the licence shall be

granted 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 training for its

private security guards and supervisors required under sub-rule (2) of rule 8 of

these rules;

(iii)

The applicant continues to adhere to the licence conditions;

(iv)

The applicant has no criminal antecedents as may be verified from a

database of crime and criminals.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Verification of character and antecedents of the private security guard

and supervisor. - (1) Before any person is employed or engaged as a security guard or

supervisor, the Agency shall satisfy itself about the character and antecedents of such

person in any one or more of the following manner, namely:-

(a) by relying upon the character and antecedents verification certificate

produced by the person issued by concerned jurisdictional Police district and

produced in original.

Provided that the character and antecedent certificate shall be valid and

the Agency does not have any adverse report regarding the person’s character

and antecedents from any other source;

(b) by accessing electronic databases of crime and criminal like the Crime and

Criminal Tracking Networks and Systems (CCTNS), Interoperable Criminal

Justice System (ICJS) or any other database or similar records for

verification of the character and antecedents through the Controlling Authority

or the Police.

(2) The person desirous of getting employed or engaged as security guard or

supervisor shall submit Form V to the Agency. In addition, he shall submit an

Affidavit in Form VI incorporating the details in relation to the provisions contained in

sub-section (2) of section 10 of the Act.

(3) The UT Administration shall arrange to accept the fee to be deposited

electronically for character and antecedent verification.

(4) The authority to which the application is made shall ensure that character and

antecedent verification report is issued within fifteen days of the receipt of the

character and antecedent form.

(5) Character and antecedents’ verification report once issued shall remain valid for

two years irrespective of the change in employer status, (unless the applicant(s) gets

involved in a criminal case after issuing the verification report and information

regarding the same is received by the Controlling Authority).

(6) On the basis of character and antecedents’ verification, the Agency shall issue in

Form VII a character and antecedents certificate and this certificate shall not be taken

back by such Agency even if the person ceases to be the employee of that Agency.

Security Training.-(1)

The Controlling Authority shall frame the detailed

training syllabus required for training the security guards in accordance with National

Skill Qualification Framework. For entry level, this training shall be for a minimum

period of hundred hours of classroom instruction and sixty hours of field training,

spread over at least twenty working days. The ex-servicemen and former police

personnel shall however be required to attend a condensed course only, of minimum

forty hours of classroom instructions and sixteen hours of field training spread over at

least seven working days.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

(2) The training shall include the following subjects, namely:-

(a) conduct in Public and correct wearing of uniform;

(b) physical fitness training;

personnel security, household security;

(d) fire fighting;

(e) crowd control;

(f) examining identification papers including identity cards, passports and smart

cards;

(g) should be able to read and understand English alphabets and Arabic numerals

as normally encountered in the identification documents, arms licence, travel

documents and security inspection sheet;

(h) identification of improvised explosive devices;

(i) first-Aid;

(j) crisis response and disasters management;

(k) defensive driving (compulsory for the driver of Armoured vehicle and optional

for others);

(l) handling and operation of non-prohibited weapons and firearms (optional);

(m) rudimentary knowledge of Indian Penal Code, right to private defense,

procedure for lodging first information report in the police station, Arms Act

(only operative sections); Explosives Act (operative sections);

(n) badges of rank in police and military forces;

(o) identification of different types of arms in use in Public and Police;

(p) use of security equipments and devices (for example; security alarms and

screening equipments); and

(q) leadership and management (for supervisors only).

(r) refresher training course once in two years to keep the guards fit and skilled up

with the latest gadgets and technologies relevant.

(3) The security guard shall have to successfully undergo the training prescribed by the

Controlling Authority.

(4) On completion of the training each successful trainee shall be awarded a certificate

in Form VIII by the training institute.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

LGP. Kvt. J-1608/10-22/50

(5) The training certificates issued to the guards/ supervisors from Training Institutes

in one State shall be accepted in other State also.

(6) The Controlling Authority shall inspect the functioning of training facility from

time to time either by itself or through its own officers. Normally such inspection shall

be conducted at least two times every year.

(7) All the training agencies shall submit a list of successful trainees to the Controlling

Authority in the manner prescribed by it.

(8) Based on training completed and requirement of the job, private security agency

may have their own designations provided that no agency shall adopt any of the ranks

of the armed forces, paramilitary forces or State Police Forces.

(9) 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 training agency.

(10)

The Controlling Authority may review the continuation or otherwise of licence

of such security agencies which may not have adhered to the conditions of trained

personnel on its rolls.

Standard of physical fitness for security guards.-(1) A person shall be

eligible for being engaged or employed as security guard if he fulfils the standards of

physical fitness as specified below:-

(i)

Height, 160 cms (Female 150 cms), weight according to standard table of

height and weight, chest 80 cms with an expansion of 4 cms (for females no

minimum requirement for 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 in 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.

(iv) Hearing: Free from defect; should be able to hear and respond to the

spoken voice and the alarms generated by security equipments.

(v)

The candidate should have dexterity and strength to perform searches,

handle objects and use force for restraining the individuals in case of need.

(2) A candidate should be free from evidence of any contagious or infectious disease.

He should not be suffering from any disease which is likely to be aggravated by

service or is likely to render him unfit for service or endanger the health of the public.

(3) Agency shall ensure that every private security guard working for it undergoes a

medical examination after every twelve months from his last such examination so as to

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

ensure his continued maintenance of physical standard as prescribed for the entry

level.

10.

Provision for Supervisors. – (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 more

number of supervisors so that at least for every six private security guards there is one

supervisor available for assistance, advice and supervision.

11.

Appeals and procedure. – Every appeal under sub-section (1) of section 14 of

the Act shall be preferred in Form IX signed by the aggrieved person or his authorized

advocate and presented to the Home Secretary to the UT Administration in person or

in electronic or digital form or sent to him by registered post.

12.

Register to be maintained by the Agency.—The register required to be

maintained under the Act by the Agency shall be maintained electronically in Form X.

13.

Photo identity card.—(1) Every photo identity card issued by the Agency

under sub-section (2) of section 17 of the Act shall be in Form XI in form of a PVC

Card or Smart Card.

(2) The photo identity card shall convey a full-face image in color, full name of the

private security guard, name of the Agency and the employee number of the individual

to whom the photo identity card is issued.

(3) The photo identity card shall clearly indicate the individual's position in the

Agency and the date up to which the photo-identity card is valid.

(4) The photo identity card shall be maintained up to date and any change in the

particulars shall be entered therein.

(5) The photo identity card issued to the private security guard shall be returned to the

Agency issuing it, once the private security guard is no longer engaged or employed

by it.

(6) Any loss or theft of photo identity card shall be immediately brought to the notice

of the Agency that issued it.

14.

Other conditions.—(1) Notwithstanding whether the Agency mandates its

private security guards to put on uniform while on duty or not, every private security

agency shall issue and make it obligatory for its security guards to 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 whistle 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.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Form I

(See rule 3, 5)

APPLICATION FOR GRANT OF LICENCE /RENEWAL OF LICENCE TO

ENGAGE IN THE BUSINESS OF PRIVATE SECURITY AGENCY

The Controlling Authority

_____________________

The undersigned hereby applies for obtaining a licence to run the business of

operating services in the area of Private Security Agencies

Full name of the applicant:

Nationality of the applicant:

Son/wife/daughter of:

Residential Address:

Address, where the applicant desires to start his Agency:

Name of the Private Security Agency:

Additional details of the Private Security Agency (if applicable):

(a) CIN No…………………………

(b) ESI No……………………………

(d) LabourLicence No…………………….

(e) Labour Registration No…………………..

(f) GST No…………………………………

(g) Any other information………

(h) Whether the Agency has FDI? (Yes/No)……..

If Yes, Give the following information;

(i) Country of FDI :…………………………………

(ii) Name of foreign shareholder:………………….

(iii) Address of foreign shareholder :……………….

(iv) Year of investment:……………………………..

(v) No. of shares:……………………………………….

(vi) Percentage of foreign shareholding:………………

(vii) Approval details of FDI: ……………………………….

(Please attach the relevant document of FDI approval.)

Name and addresses of Proprietor, partner, Majority shareholder, Director and

Chairman of the Agency:

S.No.

Management Type

(Proprietor/Partner/Majority

shareholder/Director/Chairman)

Name

Address

DIN

No.

(if held)

ID Proof

with no.

Name and extent of facilities available:

10.

(a) Does the applicant possesses the training facility in its own or will get it on

outsourcing basis?..............……

(b) If the applicant has own training facility, please provide the following

information:

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

879/5

Owner

Private

Kuttykoya Keliyam

879/3

879/1

879/7a

897/,7A,4

879/7A

Owner

Private

760

Aboobaker ,

Muhammed

Molekkepura, Attabi

Mannathanoda

879/1,4

879/5,6

879/7B

904/4A4

Cowldar

Panadaram

220

Alikoya, Sarabi,

Muhamedkoya,Nallako

ya, Asiyomabi, Sayed

Abdullakoya,

Mullakoya,

Muthukoya,Nafeesabi

Kunjeliyam

904/2B

904/3A,4B

904/4A,3

904/4A2

Cowldar

Panadaram

Alikoya, Sarabi,

Muhamedkoya,Nallako

ya, Asiyomabi, Sayed

Abdullakoya,

Mullakoya,

Muthukoya,Nafeesabi

Kunjeliyam

904/4B

SY.NO.892

904/4A,3

904/3A

Cowldar

Panadaram

Cheriyabi

Puthiyanallala

SY.NO.890

904/3B

904/4A4

890/1A1B

Cowldar

Panadaram

170

Cheriyakoya

Kauromkakkada,

Sayedphoo Veloda

SY.NO.878

890/1D

790/1A2

890/1A1A

890/1E1A

Cowldar

Panadaram

860

Puthiyanallaal

Cheriyabi

SY.NO.889

SY.NO.891

890/1E,1B

890/1E,2

878/7

Owner

Private

340

Amina

Uthambokkakada

878/4,5

SY.NO.879

878/12

878/8

Owner

Private

Amina

Uthambokkakada

878/3

878/7

878/11

878/9

878/10

Owner

Private

190

Muthukoya, Kojankoya

Avvapada

878/9

878/11

SY.NO.890

SY.NO.877

Name of training agency:

Address of training agency:

Recognition details of training agency:………………………………………….

11.

Equipments which will be used for Security services

(a) Door Framed Metal Detector (DFMD)

(b) Hand Held Metal Detector (HHMD)

(d) Other Equipments

(i) Wireless Telephones

(ii) Alarm Devices

(iii) Armoured Vehicles

(iv) Arms

12.

The particulars of the uniform including color. (Please attach color photo of uniforms).

13.

Does the applicant intends to operate in more than one districts? If so the name of the

Districts

1.______ 2._______3._______4.________5.________

14.

Does the applicant intend to operate in the entire state? Yes/No

Signature

Name of the applicant

Address of the application

Telephone number of the applicant

Date of application

Enclosure:

1. Photo of the premises of the Agency.

2. ID Proof of all Management personnel.

3. Recognition details of training agency (if applicable).

4. Colour photo of uniforms.

5. Documents (if applicable) under the agency details given in Para 7 above.

6. Copy of current Income tax Clearance Certificate.

7. Affidavit as prescribed in Section 7 sub-section (2) of the Act

8. Other enclosures.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

भारत सरकार/GOVERNMENT OF INDIA

लक्षद्वीप प्रशासन /LAKSHADWEEP ADMINISTRATION

समाहताा कायाालय (COLLECTORATE)

कवरत्ती/KAVARATTI- 682

555

फ़ोन/ Phone: 04896- 262384, 262279, 263974 ईमेल/ E-mail ID: [email protected] or [email protected]

FORM II

[See rule 5(1)]

PRELIMINARY NOTIFICATION

[Under Section 11 (1) of the RFCTLARR Act, 2013]

F.No.34/41/2021-LR

Dated. 10.10.2022

Whereas it appears to the appropriate Government that a total of 1.095 hectares

(10950 Sqm) land is required in the Kavaratti Village (Dweep) Panchayath of Kavaratti

Taluk, Lakshadweep District for public purposes, namely, Construction of Govt. Senior

Secondary School at Kavaratti. Social Impact Assessment Study was carried out by SIACS

and a report submitted. Appraisal of the SIA Report was done by an independent

multidisciplinary expert group constituted by the appropriate Government of UT of

Lakshadweep u/s 7 of the Act/ Preliminary investigation was conducted by a committee of

officers constituted by Collector (LA) as laid down under rule 4. The summary of the Social

Impact Assessment Report/ preliminary investigation is as follows (Copy of SIA report is

attached as Annexure-I).

Therefore, it is notified that for the above said project in the Kavaratti Village of

Kavaratti Taluk, Lakshadweep District a piece of land measuring, 1.095 hectares (10950

Sqm) of standard measurement, whose detail description is as following, is under acquisition:

Sl.

Survey

No.

Type of

title

Type of

land

Area

under

acquisitio

n (in Sqm)

Name and address of

person interested

Boundaries

N E

923/9B

Cowldar

Pandaram

660

Ayshabi Eakarapalli

923/10

924

923/18B

923/9A

923/14B

Cowldar

Pandaram

1220

Sayed Mohammedkoya

Koliyala, Cheriyakoya,

Muthukoya,Shaikoya,

Ayshabi,Muthbi

Melilapura

923/18

923/15

923/16B

923/14A

Form II

(See rule 3 and 5)

Form for verification of Antecedents of Applicant

NOTE: If the applicant is a company, a firm or an association of persons, this form shall

be filled up by every proprietor or majority shareholder, partner or director of the

company, as if they are also the applicants.

Signature of the Applicant ----------------------------------------------------------------

For official use only

Form number

Antecedents verification issued by :

Date

Fee Amount Rs. --------------Cash /D.D. -------------Name of Bank ------------ D.D No. --------

---

Date of Issue ---------------

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 licence)

1. Name of applicant (Initials not allowed)

Last name -------------------------------- First name-------------------------------

2. If you have ever changed your name, please indicate the previous name(s) in full

-------------------------------------------------------------------------------------------------------

3. Sex (male / female). ---

4. Date of Birth (DD/MM/YYYY): ------------------------

5. Aadhaar No.____________________

6. PAN No.________________________

7. Place of Birth: Village / Town -----------------------

District ---------------------------State and Country -------------------------------

8. Father's Full Name/ Legal Guardian's Full Name (including surname, if any): (Initials not

allowed) ---------------------------------------------------------------------------

9. Mother’s Full Name (including surname, if any): (Initials not allowed)

--------------------------------------------------------------------------------------------------

10. If married, Full Name of Spouse (including surname, if any). (Initials not allowed)

------------------------------------------------------------------------------------------------------

11. Present Residential Address, including Street No./police station, village and District (with

PIN code)

--------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------

Telephone No./Mobile No.-----------------------------------------------------

12. Please give the date since residing at the above-mentioned address: (DD/MM/YYYY)------

-------------------------------------------------------------------------

13. Permanent Address including Street No./police station, village and District ( PIN code) ----

--------------------------------------------------------------------------------------------------------------

---------------------------------------------------------------------------

14. If you have not resided at the address given at COLUMN (11) continuously for the last

five years, please furnish the other address (addresses) with duration(s) resided.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

From …………….To.……………

Address

___________________________

_____________________________

___________________________

_____________________________

15. In case of stay abroad particulars of all places where you have resided for more than one

year after attaining the age of twenty-one years. --------------------------------

16. Other Details:

(a) Educational Qualifications. :

(b) Previous positions held if any along with name and address of employers:

(d) Visible Distinguishing Mark:

(e) Last 3 years IT Return:

S. No. Assessment Year

Copy of ITR enclosed (Yes/No)

…………….

…………………….

……………..

……………………..

…………………

………………………..

(f) Affidavit incorporating the provisions of Section 6 of the Act enclosed: Yes/No

17. Did you earlier operated any Private Security Agency or were its partner, majority

shareholder or Director? If yes then furnish the name, address of the Agency and its licence

particulars. …………………………………………………………………..

18. Are you a citizen of India by: Birth/ Descent/Registration/Naturalisation: If you have ever

possessed any other citizenship, please indicate previous citizenship ……………………….

19. Have you at any time been convicted by a court in India for any criminal offence and

sentenced to imprisonment? If so, give name of the court, case number and offence. (Attach

copy of judgment) ……………………………………………………………………………

20. Is/Are any criminal proceeding(s) pending against you before a court in India? If so, give

name of court, case number and offence

………………………………………………………………………………………

21. Self- Declaration:

The information given by me in this form and enclosures is true and I am solely responsible

for accuracy.

(Signature of applicant)

Date………….

Place …………

Enclosures:

………………………………………………………………………………………………

………………………………………………………………………………

(Signature of applicant)

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Form-III

(See rule 3(2)/ rule 5(1))

Affidavit

I……………………………S/o / D/o / W/o Mr./Ms. ……………………..resident of

……………………………..is

Proprietor/

Partner/

Director

M/s………………………….. (Name of firm/agency/company) at ……………………….

(Address of firm/agency/company). I do hereby solemnly affirm and declare as under:

1. That the deponent is a citizen of India.

2. That the deponent has attained the age of 18 years.

3. That the details of the Proprietor/ Partners/ Directors (Please indicate the details of all

the Partners/ Directors) are as under:

No.

Name

the

Proprietor/

Partners/

Directors

Designations

the

firm/agency/company

(Proprietor/

Partner/

Director)

Residential Address

4. That the deponent or any of the Proprietor/ Partner/ Director has not been convicted

of any offence in connection with promotion, formation or management of a company

(any fraud or misfeasance committed by him in relation to the firm/agency/company),

including an undischarged insolvent.

5. That the deponent or any of the Proprietor/ Partner/ Director has not been convicted

by a competent court for an offence, the prescribed punishment for which is

imprisonment of not less than two years.

6. That the deponent or any of the Proprietor/ Partner/ Director has not been -

(a) keeping links with any organisation or association which is banned under any law

on account of their activities which pose threat to national security or public

order; or

(b) indulging in activities which are prejudicial to national security or public order.

7. That the deponent or any of the Proprietor/ Partner/ Director has not been dismissed

or removed from Government service on grounds of misconduct or moral turpitude.

8. That the firm/agency/company is registered in India and does not have a proprietor or

a majority shareholder, partner or director, who is not a citizen of India.

9. That the deponent and all the Partner/ Director of the firm/agency/company shall

comply with the provisions of sub-section (2) of section 9 of the Private Security

Agencies (Regulation) Act, 2005 (Central Act29 of 2005) by ensuring

availability/imparting of such training and skills to its private security guards and

supervisors as prescribed.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

10. That the deponent and all the Partner/ Director of the firm/agency/company shall

fulfill the following conditions of licence as stipulated under section 11 of the Private

Security Agencies (Regulation) Act, 2005 (Central Act29 of 2005).

(i)

prescribed training which the licensee is to undergo;

(ii)

details of the person or persons forming the agency;

(iii)

obligation as to the information to be provided from time to time to the

Controlling Authority regarding any change in their address, change of

management;

(iv)

obligation as to the information to be provided from time to time to the

Controlling Authority about any criminal charge made against them in the

course of their performance of duties of the private security agency or as the

case may be, a private security guard employed or engaged by them.

(v)

Competent authority in the UT Administration may verify about imparting of

required training by the private security agency under sub-section (2) of

section 9 of the Act and may review continuation or otherwise of licence of

the private security agency if the agency have not adhered to the condition of

ensuring the required training.

11. That there are no cases registered with police or pending in court of law against the

deponent.

That there are cases registered with police or pending in court of law against the

deponent. (Details shall be enclosed)

12. That the deponent and all the Partner/ Director of the firm/agency/company will

comply, conditions of licence and in letter and spirit, with the provisions of the

Private Security Agencies (Regulation) Act, 2005 (Central Act29 of 2005) and the

relevant rules notified by the UT Administration under the Act and also comply with

the instructions issued from time to time by the Controlling Authority appointed

under the Act, while managing private security agency with the name and title

M/s……………………………………..

Deponent

Verification:- I,…………………………. hereby solemnly affirm on ………..(date)

that the contents of above this affidavit are true and correct to the best of my

knowledge and belief nothing has been concealed therein.

Deponent

Note: (i) Point No. 4 to 8 relates to compliance of section 6 of the Act.

(ii) Point No. 9 relates to compliance of section 9(2) of the Act.

(iii) Point No. 10 and 11 relates to compliance of section 11 of the Act.

(iv) Strike the points which are not applicable.

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

From IV

(See rule 3(9))

GOVERNMENT OF______________

Licence to engage in the business of Private Security Agency

Serial No---------

Date--------------

Name of the Private Security Agency:……………………………….

Shri.---------------------------------------------------(name of the Applicant)

S/o ---------------------------------------------------------------r/o--------------------

-------------------------------------------------------------(Full Address)----------------------------------

----------------------------------is granted the licence by the Controlling Officer for the State of --

---------------------------------------------- to run the business of Private Security Agency in the

district(s) of / State of ( strike of the inapplicable words) --------------------------------------------

-------------------------------------------------------------with office at ………(address of the office)

Place of Issue ----------------

Date of issue ------------------

This license is valid up to ---------------------------------

Signature

Name of granting authority

Designation

Official Address

RENEWAL

(See rule 5(4))

Sl. No.

Date of Renewal

Date of expiry

Signature

Name of renewing authority

Designation

Official Address

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Form V

(See rule 7(2))

Form for verification of Character and antecedents of

Security Guard and Supervisor

Signature of the Applicant ---------------------------------

For official use only

Form number

Character & antecedents verification issued by :

Date

Fee Amount Rs. ------------Cash /D.D ------------Name of Bank ------------ D.D No. -----

Date of Issue ---------------

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 employment

/engagement in the Private Security Agency.)

1. Name of applicant as should appear in the photo-identity card (Initials not allowed)

Last name _________________ First name____________________________

2. If you have ever changed your name, please indicate the previous name(s) in full

_________________________________________________________________

3. Sex (male/female). _________________________

4. Date of Birth (DD/MM/YYYY): _____________

5. Aadhaar No.______________________________

6. Place of Birth: Village / Town ________________

District

______________________State

and

Country

__________________________________

7. Father's Full Name/ Legal Guardian's Full Name (including surname, if any): (Initials not

allowed) ------------------------------------------------------------------------------------

8. Mother’s Full Name (including surname, if any): (Initials not allowed)

--------------------------------------------------------------------------------------------------

9. If married, Full Name of Spouse (including surname, if any). (Initials not allowed)

------------------------------------------------------------------------------------------------------

10. Present Residential Address, including Street No. /police station, village and District (with

PIN code)

-----------------------------------------------------------------------------------------------------------

Telephone No./Mobile No.------------------------------------------------------------------------

11. Please give the date since residing at the above mentioned address: DD/MM/YYYY

---------------------------------------------------------------------------------------

12. Permanent Address including Street No./police station, village and District (with PIN

code)----------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------

13. If you have not resided at the address given at COLUMN (10) continuously for the last

five years, please furnish the other address (addresses) with duration(s) resided.

From …………….To.……………

Address

___________________________

_____________________________

___________________________

______________________________

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

14. In case of stay abroad particulars of all places where you have resided for more than one

year after attaining the age of twenty-one years.

……………………………………………………………………………………………

15. Other Details:

(a) Educational Qualifications: ……………………………………………………..

(b) Previous posts held along with name and address of employer:………………

…………………………………………………………………………………………

….

(d)Visible Distinguishing Mark on body: …………………………………………………

(e) Height (cms):……………………………………….

(f)Affidavit incorporating the provisions of Section 10 (1) & (2) of the Act enclosed: Yes/ No

16. Are you working in Central Government/ State Govt/ PSU/ Statutory Bodies: Yes/ No

17. Are you a citizen of India by: Birth/Descent/Registration/Naturalisation: If you have ever

possessed

any

other

citizenship,

please

indicate

citizenship………………………

18. Have you at any time been convicted by a court in India for any criminal offence &

sentenced to imprisonment? If so, give name of the court, case number and offence.

(Attach

copy

judgment)

………………………………………………………………………

19. Is/Are any criminal proceeding(s) pending against you before a court in India? If so, give

name of court, case number and offence ………………………………………………

……………………………………………………………………………………………

20. 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 court, case number and

offence.……………………………………………………………………………………

…

21. Self Declaration:

The information given by me in this form and enclosures is true and I am solely

responsible for accuracy.

22. Finger Prints:

(Signature of applicant)

Date ………….

Place …………

Enclosures:

…………………………………………………………………………………………………

…

…………………………………………………………………………………………………

…

(Signature of applicant)

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Form-VI

(See rule 7(2))

Affidavit

I……………………………S/o / D/o / W/o Mr./Ms. ……………………..resident of

…………………………….. (Residential Address) offer myself for employment as a private

security guard/supervisor in the private security agency M/s………………………….…..

(Name

firm/agency/company)

……………………….(Address

firm/agency/company). I do hereby solemnly affirm and declare as under:

1. That I am a citizen of India.

2. That I have attained the age of 18 years but have not attained the age of 65 years. My

date of birth is………………..

3. That I have not been convicted by a competent court.

4. That I have not been dismissed or removed on grounds of misconduct or moral

turpitude while serving in any of the armed forces of the Union, State Police

Organisations, UT Police, Central or State Governments or in any private security

agency.

Deponent

Verification:- I,…………………………. hereby solemnly affirm on ………..(date)

that the contents of above this affidavit are true and correct to the best of my

knowledge and belief nothing has been concealed therein.

Deponent

Note: The provisions of section 10(2) of the Private Security Agencies (Regulation) Act,

2005 (Central Act29 of 2005) may be printed at the back of affidavit for awareness of

deponent as follows:

―Section 10. Eligibility to be a private security guard.

(2) No person who has been convicted by a competent court or who has been

dismissed or removed on grounds of misconduct or moral turpitude while serving in

any of the armed forces of the Union, State Police Organisations, Central or State

Governments or in any private security agency shall be employed or engaged as a

private security guard or a supervisor.‖

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

FORM VII

(See rule 7(6))

CHARACTER AND ANTECEDENT CERTIFICATE

(This certificate is issued under the provisions incorporated in the rules of

the Private Security Agencies (Regulation) Act, 2005.)

This is to certify that Mr. /Ms. ………………….. , 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(es) continuously for the last one year

………

…………………………………………………………………………………………………

……

Date of Birth

Place of Birth

Educational Qualification:

Profession:

Present Address

Permanent Address

This certificate is issued on the basis of …………………. (Source of certificate) and shall be

valid upto a period of five years from its date of issue.

Issuing Authority

Signature

Name

Designation

Address/Tel.No.

Date of Issue

THE LAKSHADWEEP GAZETTE EXTRAORDINARY

Form X

(See rule 12)

Register of Particulars

(Register A: Management details)

No.

Name of

person(s)

managing

the

Agency

Parent’s/

Father’s

name

Present

address&

phone no.

Permanent

Address

Nationality

Aadhar

Number

Date of

joining/leaving

the agency

(Register B: Private Security Guards and Supervisor)

Sl.

No.

Name of

Guard/

Superviso

Father’s

name

Present

address

& phone

no.

Date of

Joining/

leaving

the

Agency

Permanent

Address

Photo

graph

Finger

Prints

Employee

No.

Aadhar

Number

Salary

with date,

ESI, EPF

numbers

and

Bank/Bra

nch

through

which

paid.

(Register C: Customers)

Sl.No.

Name of the

Customer &

phone no.

Address

of the

place

where

Security

provided

Number

and

ranks of

Security

Guards

provided

Date of

commencement

of services

Date of

discontinuation

of services

(Register D: Duty Roster)

No.

Name of the

Private

Security

Guard

/Supervisor

Address

of the

place of

duty

Whether

provided with

any

arms/ammunition

Date and time

commencement

of duty

Date and time

of ending of

duty