You are on page 1of 2

Affidavit

I, Ms. Memonn Nisha D/O Muhammad Ibrahim Mother’s Name: Khair un Nisa Tel No.____________ R/O makan
number 167, muhala sachal sarmast colony Hosree Hyderabad.

Do hereby solemnly affirm and declare on oath that:

I have obtained two CNIC/NICOP/CRC bearing numbers (1) 41204-3726969-8 (2) 41204-0353588-0respectively
with details as per detail column mentioned below, due to some mistakes of facts on my part for which I submit my
unconditional apology and surrender one of the CNIC/NICOP/CRC bearing number 41204-0353588-0 to NADRA
authorities for cancellation/necessary action along with connected transactions.

I hereby assure NADRA authorities that I had no mala fide intentions in obtaining double CNICs and will be liable
for any legal action, if any subversive intentions are detected on my part later on.

I also assure that the CNICs being produced for cancellation has not been used in any of activity by me and NADRA
has authority to cancel all the connected transactions made by me against surrendered CNIC 41204-0353588-0 if any
i.e. Bank account, Mobile connections, passport , other transactions etc. I take full responsibility and liability in
relation to surrendered CNIC and its connected transactions.

Detail Column:

Sr. Detail as per CNIC Sr. Detail as per CNIC


1 CNIC# 41204-3726969-8 1 CNIC#41204-0353588-0
2 Name: Memonn Nisha 2 Name: Memonn Nisha
3 Father’s Name: Muhammad Ibrahim 3 Father’s Name: Muhammad Ibrahim
4 Mother’s Name: Khair un Nisa 4 Mother’s Name: Khair un Nisa
5 Date Of Birth: 1962 5 Date Of Birth: 1962
6 Old NIC # Nill 6 Old NIC # Nill
7 Permanent Adress: makan number 167, muhala 7 Permanent Adress: makan number 167,
sachal sarmast colony Hosree Hyderabad muhala sachal sarmast colony Hosree
Hyderabad

Signature: _____________________ Deponent :

Witness# 1 : Muhammad Imran CNIC# 41204-3726969-8

CNIC # 41504-0510006-7

Signature: _____________________

Witness# 2 : Muhammad Rahat Khan

CNIC # 41204-0952448-9

Attested By:

Oath Commissioner
Detail Column:

Sr. Detail as per CNIC Sr. Detail as per CNIC


1 CNIC# 41204-3726969-8 1 CNIC#41204-0353588-0
2 Name: Memonn Nisha 2 Name: Memonn Nisha
3 Father’s Name: Muhammad Ibrahim 3 Father’s Name: Muhammad Ibrahim
4 Mother’s Name: Khair un Nisa 4 Mother’s Name: Khair un Nisa
5 Date Of Birth: 1962 5 Date Of Birth: 1962
6 Old NIC # Nill 6 Old NIC # Nill
7 Permanent Adress: makan number 167, muhala 7 Permanent Adress: makan number 167,
sachal sarmast colony Hosree Hyderabad muhala sachal sarmast colony Hosree
Hyderabad

Signature: _____________________ Deponent :

Witness# 1 : Muhammad Imran CNIC# 41204-3726969-8

CNIC # 41504-0510006-7

Signature: _____________________

Witness# 2 : Muhammad Rahat Khan

CNIC # 41204-0952448-9

You might also like