11. If you have ever been known by any other names including by deed poll, previous marriage or use of your name in Irish,
please provide them.
Name (as it appears on your birth certificate)
Police Certificate Application Form
This Application Form must be completed using BLOCK CAPITALS
Notes: Police Certificates are issued solely for information for the following purposes:-
Foreign Consular Authorities
Foreign Visas
Establishing a Business in another EU State
A Police Certificate CANNOT be construed as Garda vetting, a security clearance or a character reference.
Garda vetting is not conducted for persons on an individual basis. It is only conducted in respect of personnel working in full-time,
part-time, voluntary or in a student placement capacity in a position in an organisation, through which they have unsupervised
access to children and/or vulnerable adults. Garda vetting application forms can only be obtained from an organisation registered
with the Garda Central Vetting Unit to vet its prospective employees.
A Police Certificate is issued by the Superintendent in the District where the relevant applicant resides, or formerly resided, in the
Republic of Ireland.
The certificate is issued free of charge.
You should also include with your application:
A copy of your passport, driving license or similar for identification purposes
A stamped, self addressed envelope
Your application will take approximately three weeks to process.
1. Country
application
relates to
2. Purpose of Visa/immigration application Establishing a business in another EU state
application
3. First name(s)
4. Surname
5. First name(s)
7. Maiden name
(if applicable)
8. Date of birth 9. Gender Male Female
10. Place of
If born in the Republic of Ireland, please state County. If born abroad, please state Country.
birth
First name(s)
Surname
If you need more space for additional names please use another sheet and attach it to this application.
12. Mobile tel.
number
13. Landline tel.
number
14. Email
address
Please continue overleaf ►
Part 1: Application Details
Other purpose as required by
a foreign consular authority
(Please specify)
A Police Certificate is a certificate in respect of an individual issued by the Gardaí in certain circumstances. The certificate, which is valid for 12 months, states your name, address, date of birth and also includes
information about whether or not you have a criminal record in respect of this jurisdiction. A Police Certificate is issued by the Superintendent or Assistant Principal Officer within the Division where the relevant
applicant resides, or formerly resided, in the Republic of Ireland. Please go to our Station Directory (https://www.garda.ie/en/Contact-Us/Station-Directory/) to find out who your local station.
Police Certificates are issued solely for the following purposes:
1. Foreign Consular Authorities
2. Foreign Visas
3. Establishing a Business in another EU State
The following documents are required:
• Completed application form
• A certified copy of your passport, driving license or similar for identification purposes
• Proof of address and / or proof of previous addresses
The Police Certificate is issued free of charge and will take approximately three weeks to process.
A Police Certificate CANNOT be construed as Garda Vetting, a security clearance or a character reference. Garda vetting is not conducted for persons on an individual basis. It is only conducted in respect of
personnel working in full-time, part-time, voluntary or in a student placement capacity in a position in an organisation, through which they have unsupervised access to children and/or vulnerable adults. Garda
vetting application forms can only be obtained from an organisation registered with the Garda Central Vetting Unit to vet its prospective employees.
