(See rule 3)
The Citizenship Rules, 2009
APPLICATION FOR REGISTRATION OF BIRTH OF A MINOR CHILDAT AN INDIAN CONSULATE UNDER SECTION 4(1) OF THECITIZENSHIP ACT, 1955
Note: Please write/print in BLOCK LETTERS / PHOTO
PART I
1. / Full name of the minor child: / ______2. / Sex :
MALE / FEMALE / 3. Place & Country Birth
______
4. / Date of birth:.. / ____/ ______
5. / Mark of identification: / ______
6. / Present address:
7. / (i) Father’s full name: / ______
(ii) Citizen of India by birth/descent/registration*/naturalization
(iii) Occupation:
(iv) Passport particulars: / (a) Country______
(b)Number ______
8. / (i) Mother’s full name:
(ii) Citizen of India by birth/descent/registration*/naturalization
(iii) Occupation:
(iv) Passport particulars: / a) Country______
(b)Number ______
PART II
9. I,……………………………………………….a citizen of India and a parent of …………………………..…… to whom the foregoing particulars relate, hereby apply on behalf of my child for the registration of his birth.
Date ……………….. Signature of parent………………………
10. I,…..………………………………………………….…..being the parent of ……………………………………………….…. do solemnly and sincerely declare that my child to whom the foregoing particulars relate does not hold the passport of any other country.
11. I …………….……………..………………….do solemnly and sincerely declare that the foregoing particulars stated in the application are true and I make this solemn declaration conscientiously believing the same to be true.
Date ……………. Signature of parent………………………...
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For office use only
Made and subscribed this ………………day of ………..20…. before me.
***Signature………………………..
***Designation……………………..
* If a citizen of India by registration or naturalization, please mention to the number and date of the certificate of registration or naturalization, as the case may be.
** Signature and designation of the officer authorized under rule 38 of the Citizenship Rules, 2009, before whom the declaration is made or oath of allegiance is taken.(i.e. any consular officer as defined in rule 2 (d) of the Citizens(Registration at Indian Consulates) Rules, 1956.
(This form complete in all respect shall be submitted in duplicate to the Indian Mission/Post in the country in which the applicant is ordinarily resident.)
DOCOUMENTS TO BE ATTACHED WITH THE APPLICATION BY THE APPLICANT
1.A copy of the birth certificate of the child.
2. A copy of the passport of both the parents.
3. A copy of the certificate of Indian citizenship if acquired by registration /naturalization.
4. A copy of the marriage certificate of the parents.