APPENDIX XVII

FORM S-1
Certificate of registration birth in a country outside Pakistan of a child born to a citizen of Pakistan
(Vide Rule 21 of the Pakistan Citizenship Rules)

WHEREAS AB______________________________________________________________
has reported the birth of a child named ________________________________________ son/daughter of
__________________________________________________ alleging with respect to that child and
himself the 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 purposes of the
Pakistan Citizenship Act and the Rules made thereunder.

In witness whereof I have hereto subscribed my name this day of ____________________________ 1999.

Signed _________________________
(Pakistan Representative in the country outside Pakistan)

PARTICULARS RELATING TO THE CHILD AND APPLICANT

Full name of the child ________________________________________________________________

Father’s name: ______________________________________________________________________

Address in Pakistan: Address outside Pakistan:

……………………………………. ………………………………………

……………………………………. ………………………………………

……………………………………. ………………………………………

Date of birth of the child: _________________________

Place of birth: City____________________ State______________ Country___________

Mother’s name: __________________________________________________________

Address in Pakistan: Address outside Pakistan:

……………………………………. ………………………………………

……………………………………. ………………………………………

……………………………………. ………………………………………

Name of the applicant: _____________________________________________________

Address in Pakistan: Address outside Pakistan:

……………………………………. ………………………………………

……………………………………. ………………………………………

……………………………………. ………………………………………

Marks of identification of the child

Photograph
Of the child

Signed _________________________

(Pakistan Representative in the country outside Pakistan)

This form to be used if you wish to register your child born in USA.

Requirements:

1. The above form must be filled out completely.

2. Notarized copy of father’s Pakistani Passport and National I.D. Card.
3. Original or notarized copy of the child’s birth certificate.
4. A copy of father's State ID or Driver license.
5. Two photographs of the child.
6. US $ 5.00/ $10.00 in the form of money order payable to the Consulate General
of Pakistan.
- Birth Registration fee for above $ 5.00 (7 Work days )
- Urgent fee $ 10.00 (2 Work days )