FORM I B (See rule 2A) The Citizenship Act, 1955-section 4(1) APPLICATION FOR THE REGISTRATION OF BIRTH OF A MINOR CHILD AT AN INDIAN CONSULATE UNDER SECTION 4(1) OF THE ACT. Note: Please write/print in BLOCK LETTERS 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 (with maiden surname):................. (ii) Citizen of India by birth/descent/registration */naturalization *:........ 7. Profession or Occupation of - (a) Father: ........................... (b) Mother: ........................... 8. Passport particulars of - (a) Father: ........................... (b) Mother: ........................... Application 9. I ........... a citizen of India and a parent of ......... to whom the foregoing particulars relate. I hereby apply on behalf of my child for the registration of his/her birth. Date ........ Signature of applicant......... 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 applicant........... Made and subscribed this ......day of .....20.. before me. ***Signature........... ***Designation.......... * 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. ** NOTE: In the event of the child whose particulars are given above acquiring or obtaining the passport of any other country subsequent to the making of this application, the said child shall cease to be a citizen of India by descent if within six months of attaining full age he/she does not renounce the citizenship of the other country in terms of section 4(1A) of the Act. *** Signature and designation of the officer authorized under rule 28 of the Citizenship Rules, 1956, 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 when completed should be submitted in duplicate to the Indian Mission/Post in the country in which the applicant is ordinarily resident.)
