RENUNCIATION OF PAKISTANI CITIZENSHIP

REQUIRED DOCUMENTS 1. Notarized copy of American Passport.

2. Application form X (4 Copies) duly attested by a Notary Public.

3. National ID card / CNIC/ NICOP in original with photocopies or an affidavit in lieu thereof duly attested by a notary public. In case of lost, police report is required. If a person does not have a CNIC/NICOP. He has to submit:

I. An affidavit stating that he does not have a CNIC or NICOP and mentioning applicant’s complete address in Pakistan

II. Two references along with their address and contact number in Pakistan

4. Original valid & expired Pakistani passports with photocopies. In case of lost, police report is required.

5. Fee US$ 30.00 + US$ 120.00 CNIC NICOP cancellation (two separate money orders). 6. Notarized request with reason of renunciation of citizenship.

7. Five colored photographs with light blue background of size “2 x 1 ½”.

8. In case renunciation is due to a federal job requirement, a letter from the requiring authority. 9. Two self addressed prepaid envelope is mandatory. (USPS Express or Priority mail envelopes with delivery confirmation only).  

CONSULATE GENERAL OF PAKISTAN 12 EAST 65th STREET NEW YORK NY 10065

TEL: (212) 879 5800 FAX: (212) 517 6987 www.pakistanconsulateny.org

APPENDIX – XIX

FORM ‘X’

(Vide Rule 19-A)

Declaration of Renunciation of Citizenship under Section 14-A of the Pakistan Citizenship Act 1951

1. I___________________________ Resident of____________________ ____________________________________am of full capacity and was born at __________________________________on__ ________ 2. I have / have not been married. 3. I am a Citizen/ national of ____________________

that country or hold valid documents assuring citizenship or nationality of that country upon renoPakistan.

4. I here-by renounce my citizenship of Pakistan. 5. I do solemnly affirm that the foregoing particulars

true to the best of my knowledge and belief.

Signature___

Place______

Date______

Attestation _____________________ Designation_____________________ Place and Date___________________

_________

Page 1 of 3

____under the law of me of the grant of uncing citizenship of

in this declaration are

_________________

_________________

_________________

Page 2 of 3

PARTICULARS

1. Full Name: _________________________________________________

2. Father’s Name: ______________________________________________

3. Nationality of Father: _________________________________________

4. Mother’s Name: _____________________________________________

5. Nationality of Mother: ________________________________________

6. Profession or Occupation: _____________________________________

7. Address: ___________________________________________________

8. Place and Date of Birth: _______________________________________

9. Second (new) Nationality: _____________________________________

10. Single/ married/ widow or divorced: _____________________________

11. Name of the wife or Husband: __________________________________

12. Names and full particulars of minor children, if any, residing abroad, at

the time of making declaration :

Name Sex Date and place of birth

(a) ____________________ ________ ____________________

(b) ____________________ ________ ____________________

(c) ____________________ ________ ____________________

13. Applicant’s full address in Pakistan: _____________________________

_____________________________________________________________

_______________________________________

Signature or thumb impression

CONSULATE GENERAL OF PAKISTAN  12 EAST 65TH STREET  NEW YORK NY 10065  www.pakistanconsulateny.org  

 COMPUTER PROFORMA  

 LOCATION                 SERIAL NO.  1. MINISTRY __________________________________________________________________  

2. DEPARTMENT: CONSULATE GENERAL OF PAKISTAN, NEW YORK NY  

3. SUBJECT OF THE CASE: ___________________________________________________  

4. FULL NAME / MR / MRS / MISS: ____________________________________________  

5. DATE OF BIRTH:                                          6.      SEX:        MALE          FEMALE  

7. FATHER’S / HUSBAND’S NAME: ____________________________________________  

8. PROFESSION / DESIGNATION: ______________________________________________  

9. PASSPORT NO.: ______________________ 10. NATIONALITY: ____________________ 

11. PRESENT ADDRESS IN PAKISTAN: _________________________________________  

12. PERMANENT ADDRESS: _____________________________________________________  

13. VISIT SPONSORED BY: _______________________________________________________ 

14. PURPOSE OF VISIT / EXTENSION IN STAY: ________________________________ 

15. CONTACT NUMBER IN USA: ________________________________ 

FOR THE USE OF CLEARING AGENCY  

  CLEARED             / NOT CLEARED                                    C/N CLEARING CRITERIA (R/G)   

       REFERENCE NO.________________________                   DATED:   

   

Page 3 of 3