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APPLICATION FOR DUAL NATIONALITY

Embassy of Bangladesh 3510 Intern atio nal Dr., NW, Was hin gto n, D C , 20008, USA TEL- (20 2) 244 0 1 83 , Ext: 115/100 FA X (20 2) 244 7248 W E B - d emb assy u rg APPLICATION FOR dual NATIONALITY Please note that three (3) sets of t he entire APPLICATION form including attachments need to be submitted Please attach /staple 4 copies of 40mm X 50mm (passport size photographs) taken within the last six months (two copies with the first PLEASE FILL IN THREE COPIE S OF T HIS F RO M . P LEASE T YP E OR P RIN T I N BL OC K LETTERS . UN LE SS O TH ER WI SE ME NTIONED, PLE ASE C OMPLE TE AL L ITEM S OR WRIT E "N/A" (N OT APP LIC ABLE) )IF NEEDED.

AFFIDAVIT FOR DUAL NATIONALITY CERTIFICATE (Page 5 of the application set) I, ( name) Son of Daughter of Spouse of Present address (in the United States) P ermanent add ss (in Banglad sh)

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  Applications, Dual, Nationality, Application for dual nationality, For dual nationality

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