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The document is a renunciation certificate declaring the renunciation of Indian citizenship upon acquiring citizenship of another country. It contains details such as the declarant's name and address, marital status, date and place of acquiring foreign citizenship and passport number, renunciation of Indian citizenship and surrender of Indian passport, father's name, date of birth, and particulars of minor children who are Indian citizens. The declarant solemnly declares the particulars stated are true and the certificate is signed and dated.

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207 views

Please Select

The document is a renunciation certificate declaring the renunciation of Indian citizenship upon acquiring citizenship of another country. It contains details such as the declarant's name and address, marital status, date and place of acquiring foreign citizenship and passport number, renunciation of Indian citizenship and surrender of Indian passport, father's name, date of birth, and particulars of minor children who are Indian citizens. The declarant solemnly declares the particulars stated are true and the certificate is signed and dated.

Uploaded by

tobedoc
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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RENUNCIATION CERTIFICATE

DECLARATION OF RENUNCIATION OF CITIZENSHIP OF INDIA ON


ACQUISITION OF CITIZENSHIP OF ANOTHER COUNTRY
1. I _____________________________________________________ (here insert name and address of
declarant) am of full age and capacity and was born at (with Tehsil, District, State and Country)
______________________ on __________________.
2. IPlease
have/have
not------>
been married.
Select
3. I have acquired US/Foreign nationality on _______________ and consequently have obtained
US/Foreign passport no. : ______________ dated ________________.
4. I hereby renounce my citizenship of India and surrender my Indian Passport No: ______________
Date of Issue: ____________Place of Issue: _________________
5. Fathers Name: ______________________
6. Applicant's Date of Birth: ___________________________
7. Names and full particulars of my minor children, if any, who are/were Citizens of India
____________________________________________________________________________

I, ____________________________________________ do solemnly and sincerely declare that the


foregoing particulars stated in this declaration are true and I make this solemn declaration conscientiously
believing the same to be true.
Made and subscribed this __________ day of __________________
Phone No:
E-mail:
US Address:

Name:
Signature:

Surrender Certificate
Date: ____________

This is to certify that Mr./Ms. __________________________________ has renounced


his/her Indian
citizenship and acquired ___________________ (name of the country) Citizenship.
His/Her Indian Passport mentioned above has been cancelled and returned to the
passport holder.
Signature & stamp (Consulate Officer)

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