UNDERTAKING

(For Lost Card)

I ___________________________S/O D/O W/O _________________________

DOB_____________ do hereby solemnly affirm and declare on oath that I have lost my CNIC /
NICOP / S.CNIC/ S.NICOP # ________________________.

I hereby assure NADRA authorities that I will return my lost card if found in future as I cannot
keep both cards.
I hereby assure NADRA authorities that the above statement is based on fact and will be liable
for any legal action, if any subversive intentions are detected on my part later on.

Applicant’s (Father/Mother or Guardian - in case of minor) Signature___________________

Thumb _________________
CNIC/NICOP #_____________________
Dated ____________________________
Contact # _________________________

Witness 1
Name _______________________________
CNIC/NICOP # _________________________
Signature _____________________________
Contact # _____________________________
Witness 2
Name _____________________________
CNIC/NICOP # ________________________
Signature ___________________________
Contact # ___________________________