APPENDIX XIV

FORM “P-1”
No. __________________________ Date: ________________

THE PAKISTAN CITIZENSHIP ACT, 1951 (II OF 1951) AND

RULES MADE THEREUNDER (VIDE RULES 23)

CERTIFICATE OF DOMICILE

Where’s __________________ has applied for a certificate of domicile under the

Pakistan citizenship Act 1951 (II of 1951) alleging with respect to himself here is the particulars
set on below, and has satisfied the undersigned that the condition laid down in section 17 of the
said Act, for the grant of the certificate of domicile are fulfilled in the _____________________.
Now, therefore, in pursuance of the powers conferred by the said ___________________ Act

and the rules made there under the undersigned hereby grant to the said this certificate of
domicile.
In witness where of I have to subscribed my name this day of _________2013.
Signed: _________________________________________

Name __________________________________________

District Coordination Officer ________________________

PARTICULARS RELATING TO THE APPLICANT

Full Name: _______________________
Father’s Name: _______________________
Address in Pakistan: _________________________________________________________________
Cell NO# _____________ Address in the country outside Pakistan
Place Tehsil District_____
Place of Domicile
Prov/Admn/West Pakistan
Date of arrival in the Place of Domicile:
Married/Single/Widow/Widower
Name of wife or husband
Date of Birth.

Name of children and their ages:,

Nil
Nil
Nil PHOTO
Nil
Nil
Trade or Occupation Student
Marks of Identification: NIL

Date: ______/______/2013. District Coordination Officer

Rawalpindi.