DOMICILE SUBMISSION FORM

Diary No.

Date of
Submission

Full Name Father’s Name

Full Address

District MULTAN

Date of Arrival Occupation

Mark of
Date of Birth
Identification
Marital
CNIC NO.
Status
Spouse
Mobile NO. -
Name
Relative / Relative / Attendant’s
Attendant’s Name
SELF Contact No.
ATTACHED DOCUMENTS (tick the relevant box)
CNIC Father CNIC Husband CNIC Birth Certificate Bank Receipt

Photographs Property Documents Utility Bill Resident Certificate School Certificate

Voter List Duly Filled P1 Form Domicile Affidavit Form B -

CHILDREN INFORMATION (write age in years only) IF MARITAL STATUS IS NOT SINGLE
Child’s Name Age Child’s Name Age
Child’s Name Age Child’s Name Age
DOMICILE RECEIVER’S DETAIL
Name of
MUHAMMAD WAQAS Relation with applicant
Receiver
Receiving
Contact No.
Date

Applicant’s Signature
 INDEX FORM
VERIFICATION OF CREDENTIALS FOR PREPARATION OF DOMICILE CERTIFICATE
Name with
S/D/O
Parentage
Complete
Address
Property
(if any) N/AP

CNIC #s

SELF
(CNIC / FORM-B)

FATHER / MOTHER

ATTACHED DOCUMENTS

School / College Certificate ATTACHED

Voter List -------

Residential Certificate ATTACHED

Purpose for Certificate FOR JOB

Other Documents (if any) -------

Stamp Paper of Affidavit ATTACHED

Fee Submission through Challan No. 32 Dated

 UNDER SECTION 23 PAKISTAN CITIZENSHIP RULES,
APPENDIX XIV
FORM “P” 1
THE PAKISTAN CITIZENSHIP ACT, 1951, (11 OF 1951) & RULES MADE THERE UNDER (VIDE RULES 23)

CERTIFICATE OF DOMICILE
DISTRICT MULTAN
No. ____________ Date: ___30.11.2017
Whereas MUHAMMAD WAQAS S/D/O MUHAMMAD RAFEEQ has applied for certificate of
domicile under the Pakistan Citizenship Act 1951, (11 of 1951) stating with respect to himself / herself the
particulars set out below and satisfied the undersigned that the conditions laid down in section 17 of said act for
grant of a certificate of domicile are fulfilled in the said case of WAQAS, NOW THEREFORE, in pursuance of the
powers confirmed by the said act and Rules made there under the undersigned hereby grant to WAQAS this
certificate of domicile.
IN WITNESS WHERE of I have here to subscribe my name this_____________ day.

Signature _________________________

Name _________________________

Designation _________________________

PARTICULARS RELATING TO THE APPLICANT

Name
Father’s Name
Address in Pakistan

Address in Country outside of Pakistan NA

Place AS ABOVE Tehsil: CITY District MULTAN
Place of Domicile MULTAN Province/Admn. PUNJAB
Date of Birth
Date of arrival at the place of the Domicile: Since ( 12.12.2017 )

Single/Single/Widow/Widower SINGLE
Name of Wife or Husband N/A
Name of Children & their ages N/A
Trade or Occupation N/A
Marks of Identification MOLE ON FOREHEAD

Signature _________________________
Name _________________________
Designation _________________________
Date _________________________
 APPENDIX VIII
[ Form “P” ]
(Vide Rule 23 Pakistan Citizenship Rule 1951)
Application for a Certificate of Domicile in Pakistan
To,
The Deputy Commissioner Office,
Multan.
Sir,
S/D/O
I

Age years resident

hereby state I was formerly a resident of

City MULTAN
I have arrived in Pakistan Tehsil District
PUNJAB BY BIRTH
Province/ Admn. in Pakistan

I have residence continuously in Pakistan for a period of __SINCE (BIRTH)__ year month
immediately in proceeding this declaration and hereby my intention to domicile of Original in MULTAN
DISTRICT and with a view to require the domicile of Pakistan. I declare my intention to take up fixed addition in
Pakistan during the reminder of my life.
I further affirm that I had migrated to India and returned of Pakistan between the 1st March 1948 to that or
this application Exception valid.
Visa no. ___________N/A______________ Casted __________N/A__________
Issued by Pakistan Passport office at
Other particulars are given below

Single/Single/Widow/Widower Single

Name of Wife or Husband N/A

Name of Children & their ages N/A

Trade or Occupation JOBLESS

Marks of Identification MOLE ON FORHEAD

I do solemnly a firm that above statements is true to the best of knowledge and belief.

Attestation __________________________ Signature ____________________________

Designation _________________________ Place ____________MULTAN_(City) _________

Place and date _______________________

Certified that the
applicant S/D/W/O

to a bonafide permanent resident

of

and residing in this area by birth or more than three years.

CNIC / FORM-B # (‫)خود‬

CNIC # (‫ والدہ‬/ ‫)والد‬

TEHSILDAR
(City)

Certified that the

applicant S/D/W/O

to a bonafide permanent resident

of

and residing in this area by birth or more than three years.

CNIC / FORM-B # (‫)خود‬

CNIC # (‫ والدہ‬/ ‫)والد‬

TEHSILDAR
(SADDAR)
 CHALAN NO. 32 CHALAN NO. 32
Challan of Cash paid into the Treasury Sub-Treasury Provincial Challan of Cash paid into the Treasury Sub-Treasury Provincial
National Bank of Pakistan, Multan CENTRAL National Bank of Pakistan, Multan CENTRAL
Reserve Bank Reserve Bank
State Bank of Pakistan State Bank of Pakistan
To be filed in by the To be filed in by the
To be filled in by Remitter Departmental office or the To be filled in by Remitter Departmental office or the
Treasury Treasury
By Whom Name or Designation Amount By Whom Name or Full particles of Amount
Full particles of
of the person on
the remittances &
Head of the Order to the Designation of the the remittances Head of the Order to the
whose behalf money
authority (if any) Amount Bank person on whose & authority (if Amount Bank
is paid behalf money is paid any)

Dated Dated

C-03806 CITIZENSHIP NATIONSHEHRAZZATION

C-03806 CITIZENSHIP NATIONSHEHRAZZATION

Correct Rs.
Received & Correct Rs.
Grant Receipt Received &
Fee for Fee for Grant Receipt
Domicile Rs.200/- Domicile Rs.200/-

PASSPORT & COPYRIGHTS FEE

PASSPORT & COPYRIGHTS FEE

Signature and
Full Signature and
Designation of Full
the Officer Designation of
OTHER RECEIPT

OTHER RECEIPT
ordering the the Officer
money to be ordering the
Pakistani money to be
TOTAL Rs.200/- TOTAL Rs.200/- Pakistani

Signature To be used only in the case of Signature To be used only in the case of
Rupees (In words) Two Hundred Rupees Only Remittance to Bank through Rupees (In words) Two Hundred Rupees Only Remittance to Bank through
An officer of the Government An officer of the Government

Received Payment Dated Treasury Officer

Received Payment Dated Treasury Officer Treasurer Amount 200 Agent / Manager
Treasurer Amount 200 Agent / Manager
Date:
Date:
 CHALAN NO. 32 CHALAN NO. 32
Challan of Cash paid into the Treasury Sub-Treasury Provincial Challan of Cash paid into the Treasury Sub-Treasury Provincial
National Bank of Pakistan, Multan CENTRAL National Bank of Pakistan, Multan CENTRAL
Reserve Bank Reserve Bank
State Bank of Pakistan State Bank of Pakistan
To be filed in by the To be filed in by the
To be filled in by Remitter Departmental office or the To be filled in by Remitter Departmental office or the
Treasury Treasury
By Whom Name or Designation Amount By Whom Name or Full particles of Amount
Full particles of
of the person on
the remittances &
Head of the Order to the Designation of the the remittances Head of the Order to the
whose behalf money
authority (if any) Amount Bank person on whose & authority (if Amount Bank
is paid behalf money is paid any)

Dated Dated

C-03806 CITIZENSHIP NATIONSHEHRAZZATION

Correct Rs. Correct Rs.
Received & Received &
Grant Receipt Grant Receipt
Fee for

PASSPORT & COPYRIGHTS FEE

CITY DISTRICT
CITY DISTRICT GOVERNMENT
GOVERNMENT MULTAN
MULTAN ACCOUNT-iv
ACCOUNT-iv
Signature and Signature and
Full Full
Designation of Designation of

OTHER RECEIPT
the Officer the Officer
ordering the ordering the
money to be money to be
TOTAL Rs. Pakistani TOTAL Rs. Pakistani

Signature To be used only in the case of Signature To be used only in the case of
Rupees (In words) Remittance to Bank through Rupees (In words) Remittance to Bank through
An officer of the Government An officer of the Government

Received Payment Dated Treasury Officer

Received Payment Dated Treasury Officer Treasurer Amount Agent / Manager
Treasurer Amount Agent / Manager
Date:
Date:
 A F F I D A V I T
(By Parent / Guadiana of Child)

I S/O

CNIC# R/O:
,

do hereby solemnly affirm as under:

1. __________________________is my real son/daughter and is less than 18-years of age.

2. I affirm the truth of the statement made in application (Form-P) for issuing of a certificate of
domicile in favour of my son/daughter.

3. My son/daughter has been continually residing in Pakistan for a period not less than one year
and intends to live permanently in Pakistan.

4. My son/daughter is not a citizen or national of any other country.

5. My son/daughter is a permanent resident of City Sub-Division District Multan.

6. My son/daughter is a permanent resident of District Multan at the address given above.

7. My son/daughter has not obtained domicile certificate from any other district and he/she has
not applied for domicile certificate before this.

8. Domicile Certificate may be cancelled if any other Domicile Certificate is already issued to my
son/daughter indicating any other Sub-Division of District Multan.

Attested by:

Name: _ _ Thumb Impression: _ _

Designation: _ _ Signature: _ _

Dated: _ _ Dated: _ _

[FOR ATTESTOR] [FOR PARENT]

 A F F I D A V I T
(By Applicant)

I S/D/O

CNIC# R/O

do hereby solemnly affirm as under:

1. I affirm the truth of the statement made in application (Form-P) for issuing of a certificate of
domicile in my favour.
2. I have been continually resident in Pakistan for a period not less than one year and intend to
live permanently in Pakistan.
3. I am not a citizen or national of any other country.
4. I am a permanent resident of City Sub-Division, District Multan.
5. I am a permanent resident of District Multan at the address given above.
6. I have not obtained domicile certificate from any other district and I have not applied for
domicile certificate before this.
7. My Domicile Certificate may be cancelled if any other Domicile Certificate is already issued to
me indicating any other Sub-Division of District Multan.

Attested by:

Name: _ _ Thumb Impression: _ _

Designation: _ _ Signature: _ _

Dated: _ _ Dated: _ _
[FOR ATTESTOR] [FOR APPLICANT]
 Receipt for Domicile Certificate
Applicant Name: ________________________________ S/D/O ______________________________

Registration Serial No:____________________________ Submitted Date:_________________________

Expected date is : ____________________________

Sig: Domicile Branch

District Magistrate ___________________________________
Multan.

Receipt for Domicile Certificate

Applicant Name: ________________________________ S/D/O ______________________________

Registration Serial No:____________________________ Submitted Date:_________________________

Expected date is : ____________________________

Sig: Domicile Branch

District Magistrate ___________________________________
Multan.
 [Form V]
(vide rule 28 {and 28 B} of Pakistan citizenship Rule, 1952}
Application for copy of {citizen ship or domicile certificate or its
Replacement with changed particulars.

1. Full Name and address of applicant ___________________________________

(Block Letters)

2. Father’s Name ____________________________________

3. Numbers and date of issue of the __________________________________

Certificate of {Citizenship or domicile
previously} granted. ___________________________________

4. Authority by whom the certificate was ___________________________________

Issued.
5. Reason for asking for a duplicate certificate __________________________________
or for replacement with a new one.

6. Change of particulars desired in the certificate. _______________________________

Particulars in the certificate Particulars to be included

Previous issued in the certificate

1. 1.

2. 2.

3. 3.

4. 4.

Documentary proof of change of _______________________________________

Name or other particulars requirement
To be made in the new certificate. _______________________________________

I solemnly affirm that the above statement is true to the best of my knowledge and
belief.

Signature: _______________________________

Place: ________________________________

Date: ________________________________