APPLICATION FORM FOR OBTAINING SURRENDER CERTIFICATE by 6cTNTL

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									              APPLICATION FORM FOR OBTAINING SURRENDER CERTIFICATE

     I have acquired Canadian/Foreign nationality on (give date)
______ _____ ______. Therefore I hereby renounce my Indian
citizenship and surrender my Indian Passport. My personal
particulars are given below:

NAME
Details of Indian Passport:
           Passport Number ______________________
           Date of Issue ______________ Place of Issue ____________

In case you have obtained Canadian Passport, give details:
           Canadian Passport Number __________________
           Date of Issue ______________ Place of Issue _____________


Phone Number
E-mail address
Postal Address

           I may be issued a Surrender Certificate.

                                           DECLARATION

     I solemnly affirm that the information given here is
correct and nothing has been concealed and I am aware that it is
an offence under the Indian Passport Act 1967 to knowingly
furnish false information or suppress material information.



Place                                                            Signature
Date

Please enclose following with this form:
   1. Original Indian Passport with a copy of photo page, last page and all pages
       with observation.
   2. In case you have obtained Canadian/Foreign passport, attach a copy of its photo
       page and all pages with observation.
   3. Copy of Canadian citizenship certificate. For a sample, click here.
   4. Requisite fee (To be paid to VFS Global, our outsourcing agents.)

Please visit http://hciottawa.ca/Consular/Renunciation_fee.htm

(This form last modified on 8 Nov, 2010)

								
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