Application for a Certificate of Citizenship of …

1 APPENDIX-I FORM A (Vide Rules 3, 4, 5, 6 & 7) Application for a Certificate of Citizenship of pakistan at the Commencement of the pakistan Citizenship Act, 1951 (II of 1951) 1. Full name of applicant : (block letters) 2. Father s/ husband s name: (block letters) 3 Address in Full: in pakistan : in other country: 4. Trade or occupation: Place Tehsil 5. Place and date of birth: District Date day of 19 6. Nationality or nationalities of the applicant: 7. The applicant claims pakistan nationality because of -- (a) his own birth in the territories now included in pakistan . (b) his parents birth in the territories now included in pakistan . (c) his grand-parents birth in territories now included in pakistan . *8. The applicant claims pakistan Citizenship because of his domicile in the territories now included in pakistan and because of -- (a) (c) his (b) his parents or his grand-parents birth in the territories included in India on the 31st day of March 1937.

2 *9. The applicant claims Citizenship of pakistan for being naturalized as a British subject in pakistan and -- (a) (b) having acquired Citizenship of no other country. having acquired Citizenship of another country has before the 13th April, 1951 renounced it by depositing a declaration in writing to that effect with an authority appointed or empowered by that other government to receive it. 10. The applicant claims Citizenship of pakistan , because being ordinarily resident in a country outside pakistan he is making the declaration within one year of the 13th April, 1951 that --- (a) (b) he is not a national or citizen of that or any other country outside pakistan . that on the faith of that declaration and by reason of his (a) own birth, or (b) that of his parents, or (c) of his grand-parents, he claims to be a citizen of pakistan .

3 11. Name and address and nationality of parent or grand-parent though whose birth in pakistan or in the territories included in India on the 31st March 1937 Citizenship is claimed. (in block letters) 12. Place and date of birth Place Tehsil of parent mentioned in 11 District Date Day of 19 13. (1) Documentary evidence in support of the claim of birth of self, parent or grand-parent. (2) Documentary evidence of renunciation of other nationality; and (3) documentary evidence of domicile (1) (2) (3) Number, date and place of issue of the domicile Certificate . 14. Whether married or single, widower or widow? 15. Full name of wife or husband 16. Full names of children and their ages 17. Whether the applicant has at any time previously applied for the grant of a Certificate of Citizenship ?

4 18. Details of place where applicant was permanently residing between 14th August 1947, and 13th April 1951, or was domiciled on 13th April 1951. 14-08-1947 Place Tehsil. District. Province. 13-04-1951 Place Tehsil. District. Province.. 19. Exact date of migration from what now constitutes India, to pakistan and details of place of permanent residence in India before migration. 20. Names and complete address, with relationship, if any, of two referees in pakistan (i) (ii) 21. Whether the applicant is also a national of any other (foreign) country. If so, give particulars of nationality Certificate and passport issued by that country. I do solemnly affirm that the above statement is true to the best of my knowledge and belief.

5 Signature Place: Date: Attestation: Designation: Place and Date.