APPENDIX _____________VIII.

The Pakistan Citizenship Act, 1951(1I of 1951 and rules

made there under vide rule 23).

CERTIFICATE OF DOMICILE.
Whereas Mr/Miss/Mrs. __Nauman Sadiq_____________
S/o D/o W/o ______________________________________________________
has applied for Certificate of Domicile under Pakistan Citizenship Act, 1951
(II of 1951) alleging with respect of himself the particulars set out below, and has
satisfied the undersigned that the conditions laid down in Section 17 of the said Act
for the grant of a certificate of domicile are fulfilled in the said _____________ case.
Now therefore, in pursuance of the powers conferred by the said
Act and Rules made thereunder, the undersigned hereby grants to the
said ____________________________ this certificate of domicile.
In witness whereof I have hereto subscribed my name this day
of ______________________ 20

Name. ____________________
Designation. _______________
PARTICULARS RELATING TO THE APPLICANT.

Full Name ___________________________________________________________

Father's Name ________________________________________________________
Address in Pakistan____________________________________________________
Address in the country outside Pakistan ____________________________________
Place of Domicile (Place _________________) Tehsil ________________________
District ________________ Prov:/ Admm: __________________
Date of arrival in the place of Domicile ____________________________________
Married/Single/Widow _________________________________________________
Name of Wife or Husband ______________________________________________
Name of Children's and their ages.
1.___________________________________ 2.____________________________________
3.___________________________________ 4.____________________________________
5. __________________________________ 6.____________________________________
7. __________________________________ 8.____________________________________
9. __________________________________ 10.___________________________________

Trade or occupation.______________
Mark of identification_____________

Name ____________________
Designation ________________
No. ____________________
Date ___________________

C.13-.P(Q)1 13-4500-N us- 6-2007.