Emergency Travel

CON-ETD-DEC/14/07
Document
Declaration Form

High Commission for Pakistan 
London

DECLARATION / UNDERTAKING FOR ISSUANCE OF

EMERGENCY TRAVEL DOCUMENT

Fill in the Form in BLOCK LETTERS using black ink.

This Form can be downloaded from our Website: www.phclondon.org

Declaration

I, Mr. / Mrs. / Miss.

Son / Daughter / Wife of

solemnly declare that:

1. I entered UK on (date): on (type of visa)

2. I have lost my Pakistani Passport No. which has been reported to the police.

3. My expired Pakistani Passport is enclosed in original.

4. I am not in possession of British or any other country's passport.

5. My UK visa has already expired and I am overstaying in this country.

6. I have an original valid / expired NADRA Card and its copy is attached with this form.

7. I only have a copy of my NADRA Card

8. I have no case pending with UK Home Office OR my case has been finalized, Home Office letter attached.

9. I have no pending case with any of the UK courts.

10. UK Home Office has advised me to get an Emergency Travel Document to go back to Pakistan.

11. I have no criminal record, whatsoever during my stay in the UK.

12. I have never been involved in any criminal activity during my stay in the UK.

I solemnly declare that information submitted above is true to best of my knowledge and belief that nothing
has been concealed.

1. Signature:

2. Name:

3. Date: