FORM III (See rule 5) The Citizenship Act, 1955 -section 5(1)(d) APPLICATION FOR REGISTRATIN OF A MINOR CHILD UNDER SECTION 5(1)(d) OF THE ACT. Note: Please write/print in BLOCK LETTERS PART I PHOTOGRAPH 1. (a) Full name of the minor child:...................... (b) If he/she has been known by another name, enter that name here........................ 2. Sex: .............................. 3. Place and date of birth:....................... 4. Present address.......................... ................................. 5. (i) Father's full name: ......................... (ii) Citizen of India by birth/descent/registration*/naturalization*:........ 6. (i) Mother's full name: ........................ (ii) Citizen of India by birth/descent/registration*/naturalization*:........ 7. Grounds on which the minor's parents claim Indian Citizenship:.......... 8. Minor's details of residence in India: - With whom residing Address From To PART II Application 9. I............... am a citizen of India and a parent/guardian of .......... to whom the foregoing particulars relate. I hereby apply on behalf of my/the child for his/her registration as a citizen of India. Date ....... Signature of applicant......... 10. 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 ............. Made and subscribed this ........day ......20....before me. **Signature............ **Designation......... 11. I, the undersigned, hereby state that I am an Indian citizen otherwise than by naturalization; that I am a householder; and that I am not the solicitor or agent of.........I vouch for the correctness of the statements made by ......in his application for Indian citizenship. Date....... Signature .............. Name ............... Full postal address ............ ................... * If a citizen of India by registration or naturalization, please refer 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 28 of the Citizenship Rules, 1956 before whom the registration, declaration or oath of allegiance is made or taken.(i.e. the Collector, Deputy Commissioner, District Magistrate) (This Form complete in all respects shall be submitted in triplicate to the Collector/Deputy Commissioner/District Magistrate within whose jurisdiction the applicant is ordinarily resident for transmission to the Central Government through the State Government or the Union territory administration, as the case may be.) DOCUMENTS TO BE ATTACHED WITH THE APPLICATION BY THE APPLICANT 1. A copy of the valid Foreign passport. 2. A copy of the valid L.T.V/Residential Permit. 3. A copy of Bank challan in original amounting to Rs.250/- deposited in the State Bank of India under Head No."0070-Other Administrative Services- Other Services-receipts under Citizenship Act.
