FORM NO.32.

A
PROVINCIAL/CENTRAL Treasury/Sub Treasury National Bank of Pakistan State Bank of Pakistan.
To be filled in by the
Department officer or the treasury

To be filled in by the Remitters

By who
Tendered

Name or designation
and address of the
Person whose behalf
money is paid

Full particulars of
the remittance
and of authority
(if any)

Amount

Head of
Account

Order to
The Bank
Date

District Coordination
Officer Khushab

Fee for the issuance

of Domicile
Certificate

B03806

Signature and full

designation of the officer
ordering the money to
be paid in.

Total

Signature

Correct receive and

grant receipt

Received Payment Accountant

Date

Rupees Treasury(in words) ____________________________________________________

To be used only in the case of
remittance to bank through an officer
of the Government.
Treasury Officer
Agent/Manager

FORM NO.32.A
PROVINCIAL/CENTRAL Treasury/Sub Treasury National Bank of Pakistan State Bank of Pakistan.
To be filled in by the
Department officer or the treasury

To be filled in by the Remitters

By who
Tendered

Name or designation
and address of the
Person whose behalf
money is paid

Full particulars of
the remittance
and of authority
(if any)

Amount

Head of
Account

Order to
The Bank
Date

District Coordination
Officer Khushab

Fee for the issuance

of Domicile
Certificate

B03806

Signature and full

designation of the officer
ordering the money to
be paid in.

Total

Signature

Received Payment Accountant

Correct receive and

grant receipt

Date

Rupees Treasury(in words) ____________________________________________________

To be used only in the case of
remittance to bank through an officer
of the Government.
Treasury Officer
Agent/Manager

Jerjees Haider Shah

OFFICE OF DISTRICT COORDINATION OFFICER KHUSHAB

ACKNOWLEDGMENT
Form

for

issuance

of

Domicile

Certificate

in

respect

of

____________

______________________________________________________________________________

______________________________________________________________________________

has been received in this Office vide entry No ____________________________________

dated _____/_____/______ for grant of Domicile Certificate.

The domicile certificate will be issued after the Approval of the District

Coordination Officer Khushab on _____/_____/______.

OFFICE OF DISTRICT COORDINATION OFFICER KHUSHAB

ACKNOWLEDGMENT
Form

for

issuance

of

Domicile

Certificate

in

respect

of

____________

______________________________________________________________________________

______________________________________________________________________________

has been received in this Office vide entry No ____________________________________

dated _____/_____/______ for grant of Domicile Certificate.

The domicile certificate will be issued after the Approval of the District

Coordination Officer Khushab on _____/_____/______.

Jerjees Haider Shah

APPENDIX VIII FORM "P"

(Vide Rule 23 Pakistan Citizenship Rule 1952)
To
____________________________________________
____________________________________________

Subject:

APPLICATION FOR A CERTIFICATE OF DOMICILE IN PAKISTAN.

Sir,
I

_____________________________________________________________

Son / Daughter / Wife of _________________________________________________________

(Name in block letters) aged _____/Years _____/month_____/Days,
resident of __________________________________________________________________
hereby sate that I was formerly the resident of

___________________________________

I have arrived in _____/_____/_____ Tehsil__________________________ District KHUSHAB

Pvov./Admn ________________________________ in Pakistan on day of _____/_____/_____
immediately preceding this this declaration and intend to take up my fixed habitation in
Pakistan during the remainder of my life.
I further affirm that I have not migrated to India and returned to Pakistan
between the 1st March 1952 to the date of this application except a valid visa No
____________________dated _____/_____/_____ issued by the Pakistan Passport other
Particulars are given below.
Married/single/Widower

_____________________________________________________

Name of wife or husband

_____________________________________________________

Name of children and their ages___________________________________________________

Trade or occupation

_____________________________________________________

Marks of identification

_____________________________________________________

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

_____________________

Signature

______________________

Designation

_____________________

Place

______________________

Place and Date_____________________

Date

______________________

Jerjees Haider Shah

No. ______________________

dated _____/_____/_____

APPENDIX-XIV
FORM P.I
THE PAKISTAN CITIZENSHIP ACT, 1951 (II OF 1951)
AND RULE MADE THEREUNDER (VIDE RULE 23)

CERTIFICATE OF DOMICILE
WHEREAS _____________________________________________________________________
Son / Daughter / Wife of _________________________________________________________
has applied for a certificate of domicile under the Pakistan Citizenship Act, 1951, (II of 1952)
alleging with respect of himself/herself here is the particulars set out below and has satisfied
the undersigned that the conditions laid down in section 17 of the said act the grant of
certificate of domicile are fulfill in the said ______________________________________ Case.
NOW, THEREFORE, in pursuance of the Powers confirmed by the said Act and the rules made
thereunder, the undersigned hereby grant to the said __________________________________
this certificate of domicile.
IN WITNESS WHEREOF I have hereto subscribed my name this day of _____/_____/_____
Signed

___________________

Name

___________________

Designation

___________________

PARTICULARS RELATING TO THE APPLICANT

Full name: ____________________________________________________________________
Father's name: _________________________________________________________________
Address in Pakistan: _____________________________________________________________
Address the country outside Pakistan: ______________________________________________
Place of domicile
Place _____________________________ Tehsil______________________ District KHUSHAB
Prov/adm: ___________________________________________________________________
Date of arrival in the place of domicile _____/_____/_____
Single/married/widow/widower ____________________________________________________
Name of wife/husband ___________________________________________________________
Name of children and their ages ___________________________________________________
Trade or occupation _____________________________________________________________
Marks of identification ___________________________________________________________

PHOTO

Jerjees Haider Shah

Signed

___________________

Name

___________________

Designation

___________________

Date

___________________

OFFICE OF THE MAGISTRATE _________________DISTRICT KHUSHAB

No. ______________________

dated _____/_____/_____

Forwarded in original to the Tehsildar for favour or report on the following

points:
1. Whether the particulars contained in the application are correct.
2. Whether he recommends Use grant of a domicile certificate to applicant.
3. Whether the applicant is a Pakistani by migration or by birth if so for how long he is residing
in the place of his residence in the district.
4. It may be clearly certified that the applicant is continuously residing at the place indicated in
the application for the last two years.
5. The statement of the Member or Chairman Union Council or Lambardar or advocate should
also be recorded.

Superintendent
For District Magistrate
District Khushab

Jerjees Haider Shah

SUBJECT:

APPLICATRYN FOR THE GANT OF DOMICILE CERTIFICATE

Mr/Miss/Mrs/ ______________________________________________________

Son / Daughter / Wife of _________________________________________________________

Resident ______________________________________________________________________
Tehsil ____________________ District KHUSHAB has applied for the grant of Domicile
Certificate. The requisite fee RS ________________ has been paid by the applicant in the
Treasury vide Challan No. ____________________dated _____/_____/_____ Enclosed.
The following documents have been produced by the applicant in support of
his/her contention that he/she is a permanent resident of ______________________________
Tehsil ________________ District KHUSHAB.

Fard Arazi showing ownership/cultivation over land, or document showing title to other
property.
Verification by Revenue Officer Concerned.
Copy of Identity Card/ Father's Identity Card.
Copy of Voter's list.
Copy of Matriculation Certificate.
Affidavit Affirming the truth to the statement in the application in Form P-I
The Domicile Certificate are issued under Section 17 of the Pakistan Citizenship

Act 1951 read with Rule 23 of the Pakistan citizenship Rules,1252 and all the District
Magistrates have been empowered to issue such certificate within their respective jurisdiction
vide the Government of West Pakistan, Home Department Circular letter No. 8987 - HPP (ii) 57 ,dated 02.10.1957.
The application has been duly examined. The entire evidence placed on record
by the applicant in proof of claim has been found to be satisfactory/ unsatisfactory. The
application fulfills/does not fulfill the requisite conditions for the grant of Domicile Certificate
and his / her case is accordingly recommended/not recommended for the same.
The applicant is being directed to produce the following documents to
substantiate his/her claim:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Submitted for order please.

OFFICE INCAHRGE

PASSPORT/DOMICILE CLERK

DISTRICT KHUSHAB

Jerjees Haider Shah

Jerjees Haider Shah