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)declare that I was born of parents who are

permanently Domiciled in Khybcr Pakhtunkliwa having been bom / settled in this pfOVltlC0.
I belong by birth to Mohallah
Village
Tehsil
District Lakki M at.
Se1f/ F•ather / Brother f Husband NIC
No.
Signature of the Applicant
Dated: /2011
Pursuance to the declaration dated:
/2011 filed by
Son / daughter / \Vife
of
domicile in the Khyber Pakhtunkhwa, it is hereby ‹ierti fied that the said
is born of parents who are permanent
residents of the Ktiyber tunkhwa having been born / settled in it.

I have satisfied my self from personal knowledge / veñ rcation through


Revenue Staff that the above declaration is true & certified accordingly.

This " ’ day of ”' - 2011

Deputy District Officer ”“


Revenue & Estate / Judicial
Lakki Marwat

f Do f R&E f Lin Dated: / / 2011


ERSIGN

District Officer (R&E)


Collector.Lakki Marwat
)declare that I was born of parents who are
permanently Domiciled in Khybcr Pakhtunkliwa having been bom / settled in this pfOVltlC0.
I belong by birth to Mohallah
Village
Tehsil
District Lakki M at.
Se1f/ F•ather / Brother f Husband NIC
No.
Signature of the Applicant
Dated: /2011
Pursuance to the declaration dated:
/2011 filed by
Son / daughter / \Vife
of
domicile in the Khyber Pakhtunkhwa, it is hereby ‹ierti fied that the said
is born of parents who are permanent
residents of the Ktiyber tunkhwa having been born / settled in it.

I have satisfied my self from personal knowledge / veñ rcation through


Revenue Staff that the above declaration is true & certified accordingly.

This " ’ day of ”' - 2011

Deputy District Officer ”“


Revenue & Estate / Judicial
Lakki Marwat

f Do f R&E f Lin Dated: / / 2011


ERSIGN

District Officer (R&E)


Collector.Lakki Marwat
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