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APPLICATION TO Sd
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44 SIGNATURE OF APPLICANT (check each of the following:)
| agree to advise Immigration, Refugees nd Cilzenship Canad (IRC) if any information on this form changes before the processing of my application
is complete | undetsiand the content of this frm andthe signifies of renouncing my Canadian clzenship. | deciare tat the information provided Is
__ttue,corec and complete, and tha he photograph enclosed isa tue Tkeness of me. understand that |, o someone on my behal, make @ false
sentation, comm rad or oneal any material crcumsances relevant to my appicaton my application could be denied, my coriiate of
rion coul be take away, an | eae be charged wih an offence as prowded for under the Citizenship Act o he Criminal Coc
ste cantante fom,
cee eatin, Regees and tlensip Canad (FIC) any Information on his fom changes efor the procesing of my sppenton scampi,
rhc sigeanes of renouncing my Canale cisnaiy andthe, #aprove, los al to rhs ar prlages of beng Canaan lien enn
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conten hat wih enunce my Canaan lento he ovng ease
I want to rencunce ay Canadian citizenship becouse there is & high Likelihood to be appointed es « Minister
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23, Slaatre of APPLICANT e ace sofia mulgacta 1
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ia REMEMBER:
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u “{\tyou are sending more than one application, send all of them together in one envelope.
ie ‘The applications will be processed togethe!
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J WILL RESULT IN YOUR APPLICATION BEING RETURNED.
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Official Receipt — Regu officiel
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$100.00 CAD
CARD NUMBER ~ NUMERO DE LA CARTE:
EXPIRY DATE ~ DATE D'EXPIRATION :
CARD TYPE - TYPE DE CARTE: Visa
RECEIPT NUMBER — NUMERO DU REGU: 456661139
DATE OF 2YMENT — DATE DU PAIEMENT = 2021-04-21 05:15:19 EDTIHAE,
CARDHOLDER - TITULAIRE DE CARTE : KIRIL PETKOV
ORDER - COMMANDE: Online Payment - Paiement en ligne
AUTHORIZATION CODE ~ CODE D’AUTORISATION : 808231
Se NUMBER — NUMERO DE REFERENCE : 663252180010206310
01
|S ACTION TYPE ~ TYPE DE TRANSACTION : purchase
CODE MESSAGE—MESSAGE DE CODE DE REPONSE: 027 APPROVED 3 =
REFUND POLICY - POLITIQUE DE REMBOURSEMENT.
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\ Uniess otherwise specified, fees paid will ot be refunds:
‘yefefused by IRCC. In the event of a refund, IRCC com:
stipulates thatthe money must be returned or repaid to
foran application RCC, oF approved or
withthe Financial ion Act (FAA) which
1 person who performed the payment.
fina tn a aa ai et in bbls pr ann rr por IRC,
(Cette cong ite: Sle cnn ercomere Cwm isa tne
WES S/ finances publiques (LGFP) qui stipule que les fais doivent etre rastués @ la personne quia effectué le paiement.Ha 21.4.2021 r.,