Transcription of APPLICATION FOR THE SURRENDER OF INDIAN …
1 APPLICATION FOR THE SURRENDER OF INDIAN passport & renunciation OF INDIAN citizenship I have acquired Canadian/Foreign nationality on (Date) _____ and consequently have obtained Canadian/ Foreign passport . Therefore I hereby renounce my INDIAN citizenship and SURRENDER my INDIAN passport . My personal particulars are outlined below: (Please fill personal information as per INDIAN passport ) Given Name :_____ Surname :_____ Date of Birth :_____ Place of Birth :_____ Father s Name :_____ Mother s Name :_____ Spouse Name :_____ INDIAN passport details (Please fill in the columns below) passport Number:_____ Date of Issue :_____ Date of Expiry :_____ Place of Issue: :_____ Canadian/Foreign passport details (Please fill in the columns below) Nationality Acquired :_____ passport Number :_____ Date of Issue :_____ Place of Issue :_____ Address :_____ :_____ Phone number :_____ Email.
2 _____ I may be issued a SURRENDER certificate. I have retained a copy of my INDIAN passport and I will not ask for the same in future. DECLARATION: I solemnly affirm that the information given here is correct and nothing has been concealed and I am aware that it is an offence under the INDIAN passport Act, 1967 to knowingly furnish false information or suppress material information; Place_____ Signature_____ Date_____ Documents Required: 1. Refer BLS SURRENDER of INDIAN passport / renunciation of INDIAN citizenship checklist. 2. Relevant fee, penalties if applicable &BLS Service Charge Note: In case the INDIAN passport held at the time of acquiring Canadian citizenship is not available, a notarized affidavit explaining the circumstances of the loss/damage, detailed police report of lost passport , the passport number & date of issue/expiry must be provided, along with proof in support of the claim (For example Landing Document).
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