Document Checklist:

1. Original Document
2. Applicant’s copy of Passport,
CNIC/NICOP
3. Money Order/Banker’s
Cheque/
4. Two Passport-size Photos

Consulate General of Pakistan Vancouver

Application for Power of Attorney

Part-A
Information meant to be filled in by the Consulate General of Pakistan:
1 Request to: Consulate General Vancouver 2 Diary No.
(For office / /2019
use only)
Information of the Person giving Authority (Executor):
3 Name 4 Father’s/
Husband's Name

5 CNIC /POC No. 6 Passport

No.
7 Contact No. 8 Address

Information of the Attorney:

9 Name 10 Father’s/
Husband's Name

11 CNIC / POC 12 Passport

No.
13 Contact No. 14 Address

I _____________________________________ s/o, d/o, w/o __________________________________ do hereby

solemnly affirm and declare that the above particulars are true and correct to the best of my knowledge and belief.

Date: ____________________ Signature of the Applicant: _____________________________

PART-B
Statutory Declaration
I _____________________________________ s/o, d/o, w/o __________________________________, do hereby
solemnly affirm and declare the following as per the requirements of the Statutory Declaration Act of 1959:

i. That I hold a Pakistani Passport as per details given above (Part-A of the Application);
ii. That I hold a CNIC / NICOP which is genuine and valid (particulars mentioned in Part-A of the
Application);
iii. That whatever is declared above and in Part-A of the application form is true and correct to the best of my
knowledge and belief.

I hereby certify that I am the rightful executant of the Power of Attorney deed / document that is enclosed with
this
application for attestation by the Consulate General of Pakistan Vancouver
(strike off whichever is not applicable) / ;

I understand that if I intentionally make a false statement in a statutory declaration I will be guilty of an
offence under section 11 of the Statutory Declarations Act 1959, and I believe that the statements in this
declaration are true in every particular.

Date: _________________ Signature of the Applicant:________________________