Renunciation Of Pakistani Citizenship Page 4

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EMBASSY OF PAKISTAN
Pedro de Valdivia, 16, 28006 MADRID
TEL: 913458995 FAX: 913458158
COMPUTER PROFORMA
LOCATION: ____________________
SERIAL: ____________________
1
MINISTRY (Dealing with the case) _____________________________________________
:
2. DEPARTMENT: .
3. SUBJECT OF THE CASE: _____________________________________________________
4. FULL NAME MR/MRS/MISS: ________________________________________________
5. DATE OF BIRTH: ____________________________________________________________
6. SEX:________________________________________________________________________
7. FATHER’S/HUSBAND’S NAME: ______________________________________________
8. PROFESSION/OCUPATION:__________________________________________________
9
PASSPORT NO.:______________________________________________________________
.
10.NATIONALITY: ____________________________________________________________
11.PRESENT ADDRESS IN PAKISTAN: __________________________________________
12. PERMANENT ADDRESS: ___________________________________________________
13. VISIT SPONSORED BY: _____________________________________________________
14. PURPOSE RENUNCIATION OF PAKISTAN CITIZENSHIP
15. CONTACT NUMBER IN SPAIN: ________________________________
FOR THE USE OF CLEARING AGENCY
CLEARED/NOT CLEARED
C/N CLEARING CRITERIA R/G
REFRENCE NO.
DATED

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