Read Renunciation form text version

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. I have/have not been married. 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. 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: Documents required: 1. Indian passport in original 2. Copy of US Naturalization Certificate 3. Fee and penalty, if any 4. Return mail fee of $ 20 or return mail envelope 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. Name: Signature:

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Renunciation form

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