1. UNDER SECTION 23 PAKISTAII CITIZENSHIP RULESJ
APPENDTXXT fM
FORM rrPr I il,P'P3;
L,r{i;f"D%Date
WHEREAS.
.i':didf":ii$J SI{*&tEj,.
slo.
di il;HI ir"ji:.S-:iidL
"
has applied for a certr'ficate of domicile under the Pakistan Citizens*rip Ad, 1951.(11 d 1951) Stdiq *i$1
respect to himself/herself the partianlars set out blffi and satisfied the ur#r sryrd H th€ conditisrs
laid down in section 17 of the said act fo,r grant for a ertificate of domkjh are ft#*ed m tfte said
case i.:Ui{dti,:ri, Bi{ii}.ii!.:,.
NOW THERE FORE, in pursuance
under, the undersigned hereby grant to
lN WITNESS WHERE OF I have here to subscribd my narae 8:is
Slgndtre
n I AUG 2010
Narte
OesiWatlm
of the potrers wfirmed by Ste said AE{, d F&.iles m* fwe
:.'rl!,=ii.i'iil''*$ $E diiii{L.
PATTTICUI-ARS RELATIHG TO THE APPI.IGANT
Name i.illliaj{"i*', sH.ij(rrjjt=
Fahe/s Name iCliii):i{T i'Ill]{:il rii.*"i",.
Address in Pakistan .{. ri:c. 29- l r;o-h,.lac
Address in Country outside of P*is*an
Pbce l{x
Ealt:;:; i I
--.;.
Place of Domiclle
ProvlAdmn
T€hsil :;<
-H
};x
.-:,a l.-.1-'r4(r5dt
Date of aniyal in Plae of domicib
M a nied/Singlefi ff idour/Widower
Name of wife or husband
Name of cfrildren and their ages
Trade or Occuption Etuaent.
Marks of ldentification l"io1e on f o:'e-hsac.
sEnafure
$lac e tsii'th.
Narne