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APPENDIX XX FORM Y Vide rule 19-B Declaration of intention to resume Pakistan citizenship under section 14-A of the Pakistan Citizenship Act 1951 I. son of was born at. My father s full name is / was. I ceased to be a Pakistan citizen by virtue of clause a of sub-section 2 of section 14-A of the Pakistan Citizenship Act 1951 on. by reason of the fact. Here state the cause whereby the declarant s father and declarant ceased to be and all other relevant information. If I had not so ceased to be a Pakistan citizen I should now be a Pakistan citizen Here state the grounds on which the declarant claims that he or she would have been such a citizen. I hereby declare my intention to resume Pakistan Citizenship and apply for the registration of this declaration* I do solemnly affirm that the foregoing particulars in this declaration are true to the best of my knowledge and belief* Signature Place. Date Attestation Designation*. Place and Date. PARTICULARS Full Name Father s Name. Address. Profession or occupation. Place and date of birth Second Nationality Single married widower widow or divorced. Name of the wife or husband. Name and nationalities of parents. Names and full particulars of minor children if any. son of was born at. My father s full name is / was. I ceased to be a Pakistan citizen by virtue of clause a of sub-section 2 of section 14-A of the Pakistan Citizenship Act 1951 on. by reason of the fact. Here state the cause whereby the declarant s father and declarant ceased to be and all other relevant information. by reason of the fact. Here state the cause whereby the declarant s father and declarant ceased to be and all other relevant information. If I had not so ceased to be a Pakistan citizen I should now be a Pakistan citizen Here state the grounds on which the declarant claims that he or she would have been such a citizen. If I had not so ceased to be a Pakistan citizen I should now be a Pakistan citizen Here state the grounds on which the declarant claims that he or she would have been such a citizen. I hereby declare my intention to resume Pakistan Citizenship and apply for the registration of this declaration* I do solemnly affirm that the foregoing particulars in this declaration are true to the best of my knowledge and belief* Signature Place. I hereby declare my intention to resume Pakistan Citizenship and apply for the registration of this declaration* I do solemnly affirm that the foregoing particulars in this declaration are true to the best of my knowledge and belief* Signature Place. Date Attestation Designation*. Place and Date. PARTICULARS Full Name Father s Name. Date Attestation Designation*. Place and Date. PARTICULARS Full Name Father s Name. Address. Profession or occupation. Place and date of birth Second Nationality Single married widower widow or divorced. Address. Profession or occupation. Place and date of birth Second Nationality Single married widower widow or divorced. Name of the wife or husband. Name and nationalities of parents. Names and full particulars of minor children if any.

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