APPENDIX XI

FORM S
(Vide rule 21)
Application for registration of birth of a child of a citizen of Pakistan born in a country outside Pakistan.

To

__________________________
__________________________

Sir,
The undersigned reports the birth of a male/female child to Mr. and Mrs (in block letters)
______________________________on ____________day of _________________at __________Distt.
___________ Country_____________.
The child has been named _________________________(in block letters) I am the father/guardian
of the child and my full name and address is as follows:
Name with fathers name: ________________________________________________________
Address in country outside Pakistan: ________________________________________________
Address in Pakistan:
_________________________________________________________
I/the childs father was/was not at the time of the childs birth servant of Government of Pakistan or
of an international organization of which Pakistan was at any time during that period a member. The full
names and addresses of the childs parents are given below: Name with fathers ______________________________________
Name (in block letters)____________________________________
Fathers name and address
in Pakistan and in the country
outside Pakistan.

Address in Pakistan: _____________________________________

_____________________________________
Address in the country ___________________________________
Outside Pakistan
____________________________________
Name with fathers name: _________________________________
(in block letters) _______________________________________

Mothers name and address

in Pakistan and in the
Country outside Pakistan

Address in Pakistan: _____________________________________

_____________________________________
Address in the country ___________________________________
Outside Pakistan.
____________________________________

I am attaching the following documents in proof of my citizenship of Pakistan, and of the childs
birth as reported above: (a)
(b)
(c)

_____________________________________
_____________________________________
_____________________________________

I do solemnly affirm that the above statement is true to the best of my knowledge and belief.
Attestation: _____________________
Place :________________________

Signature: ______________________________
Designation: ____________________________
Date
:_______________________________

(Under Section 23 Pakistan Citizenship Rules)

APPENDIX XVII
FORM S-I
The Pakistan Citizenship Act, 1951 (II of 1951) and Rules made there under

Certificate of registration of birth in a country outside Pakistan of a child

Born to a citizen of Pakistan
(Vide rule 21 of the Pakistan Citizen Rules)
WHEREAS____________________________________________________ has reported
the birth of a child named ________________________________________ son/daughter of
____________________________________ alleging with respect to that child and himself
that particulars set out below.
Now, THEREFORE, in pursuance of rule 21 of the Pakistan Citizenship Rules, 1952 it is
hereby certified that the birth of the said child has been registered for the purpose of the Pakistan
Citizenship Act and the Rules made there under.
In witness whereof I have thereto subscribed my name this day of ______________20
Signed _________________________________
(Pakistan Representative in the outside Pakistan)
Particulars relating to the Child and Applicant
Full Name of the Child __________________________________________________
Fathers name and address in Pakistan and in
Name ___________________________
Country outside Pakistan
Address in Pakistan______________________
______________________________________
Address in the country outside Pakistan______
______________________________________
Date and place of birth of the child

Place ______________ Distt_______________

Country_______________________________
Date _____________________________

Name and address of childs mother in Pakistan

and in Country outside Pakistan

Name _________________________________
Address in Pakistan______________________
______________________________________
Address in the country outside Pakistan______
______________________________________
Name _________________________________
Address in Pakistan______________________
______________________________________
Address in the country outside Pakistan______
_____________________________________
_____________________________________

Name and address of the applicant

Marks of identification of the child

PHOTOGRAPH

Signed _________________________________
(Pakistan Representative in the outside
Pakistan)

(Under Section 23 Pakistan Citizenship Rules)

APPENDIX XVII
FORM S-I
The Pakistan Citizenship Act, 1951 (II of 1951) and Rules made there under

Certificate of registration of birth in a country outside Pakistan of a child

Born to a citizen of Pakistan
(Vide rule 21 of the Pakistan Citizen Rules)
WHEREAS ___MR. GHULAM M. QAMAR ___has reported the birth of a child named
__SAMAR HASSAN___ Son of _____ MR. GHULAM MUHAMMAD QAMAR ___
alleging with respect to that child and himself that particulars set out below.
Now, THEREFORE, in pursuance of rule 21 of the Pakistan Citizenship Rules, 1952 it is
hereby certified that the birth of the said child has been registered for the purpose of the Pakistan
Citizenship Act and the Rules made there under.
In witness whereof I have thereto subscribed my name this day of __24 February 2008

Signed _________________________________
(Pakistan Representative in the outside Pakistan)
Particulars relating to the Child and Applicant
Full Name of the Child ________ SAMAR HASSAN _________________________
Fathers name and address in Pakistan and in
Name GHULAM MUHAMMAD QAMAR
Country outside Pakistan
Address in Pakistan_Vill & P.O. Sagharpur
THE. Pind Dadan Khan, Dist. , Jehlum,
Address in the country outside Pakistan ___
Flat No. 5, Settlement - 3, Building No. 86,
Sector-3, New Cairo, Egypt
Date and place of birth of the child
Place __ Cairo___ Distt___ Cairo___
Country_______ Egypt _______________
Date ______3rd February 2008_________
Name and address of childs mother in Pakistan
and in Country outside Pakistan
Name and address of the applicant

Marks of identification of the child

Name ___MRS. Balqees Fatima___

Address in Pakistan___As Above______
Address in the country outside Pakistan______
_____________ As Above ______________
Name __________ As Above ____________
Address in Pakistan_____ As Above _____
Address in the country outside Pakistan______
____________ As Above ______________
__________NIL____________________
PHOTOGRAPH

Signed _________________________________

(Pakistan Representative in the outside

Pakistan)
(Under Section 23 Pakistan Citizenship Rules)
APPENDIX XVII
FORM S-I
The Pakistan Citizenship Act, 1951 (II of 1951) and Rules made there under
Certificate of registration of birth in a country outside Pakistan of a child
Born to a citizen of Pakistan
(Vide rule 21 of the Pakistan Citizen Rules)
WHEREAS ___Mr. Muhammad Kamran Abbasi ___has reported the birth of a child named
__Miss. Zainab Kamran Abbasi___ daughter of _____ Mr. Kamran Abbasi ___ alleging with
respect to that child and himself that particulars set out below.
Now, THEREFORE, in pursuance of rule 21 of the Pakistan Citizenship Rules, 1952 it is hereby
certified that the birth of the said child has been registered for the purpose of the Pakistan Citizenship Act
and the Rules made there under.
In witness whereof I have thereto subscribed my name this day of __12 June, 2007
Signed _________________________________
(Pakistan Representative in the outside Pakistan)
Particulars relating to the Child and Applicant
Full Name of the Child ________ Miss. Zainab Kamran Abbasi_________________________
Fathers name and address in Pakistan and in
Name ___ Mr. Muhammad Kamran Abbasi _
Country outside Pakistan
Address in Pakistan_ H.No. 80-St.No.111, G-11/3
Islamabad.
____
Address in the country outside Pakistan 24-Abdul
Moneam Hafiz-Street, Heliopolis Cairo Egypt.
Date and place of birth of the child

Place __ Cairo ___ Distt___ Cairo ___

Country_______ Egypt _______________
Date ______6thth January 2007 ________

Name and address of childs mother in Pakistan Name ___Mrs. Atiya Kamran Abbasi ___
and in Country outside Pakistan
Address in Pakistan___As Above______
Address in the country outside Pakistan______
_____________ As Above ______________
Name and address of the applicant
Name __________ As Above ____________
Address in Pakistan_____ As Above _____
Address in the country outside Pakistan As Above
Marks of identification of the child
__________Nil____________________
PHOTOGRAPH

Signed _______________________________
(Pakistan Representative in the outside Pakistan)