GOVERNMENT OF INDIAFORM XXII

[See rule 23 (1)]The Citizenship RULES, 2009

DECLARATION OF RENUNCIATION OF CITIZENSHIP UNDER SECTION 8 OF THE ACT MADE BY A CITIZEN OF INDIA WHO IS ALSO A CITIZEN OR

NATIONAL OF ANOTHER COUNTRY

1. I, ……………………………………………………………………… (full name

of declarant) am of full age and capacity and was born at

………………………………………………..….…….. (place of birth, with

Tehsil, District, State and Country) on ………………………. (date of birth)

2. I have / have not been married.

3. I hereby renounce my citizenship of India and surrender my Indian

Passport No. …………………………… with date of issue …………………

Or

I hereby renounce my citizenship of India. Consequent upon my

acquiring German nationality on ……………………………… (date of

acquiring Germany nationality), my Indian Passport No.

…………………………… dated …………………... has already been

surrendered to the German immigration authorities (copy of proof and a

copy of passport to be attached).

4. Name and full particulars of minor children, if any, who are Citizens of

India:- ……………………………………………………………………………

…………………………………………………………………………………...

……………………………………………………………………………………

5. I do solemnly and sincerely declare that the foregoing particulars stated

in this declaration are true and I make this solemn declaration

conscientiously believing the same to be true.

Signature ……………………..

Made and subscribed this …………. day of………………….. 20……. before me.

Signature……………………… Designation …………………...

……. 2/-

- 2 -

Particulars

1. Full name ………………………………………………………………………

2. Address in India …………………………………………………………………

……………………………………………………………………………………

……………………………………………………………………………………

3. Profession or occupation ………………………………………………………

4. Place of birth ………………………………… date of birth …………………

5. (Second) Nationality ……………………………………………………………

6. Marital Status (Single / Married / etc) …………………………………………

7. Name of wife or husband ………………………………………………………

8. Name of father …………………………………………………………………

9. Nationality of father ……………………………………………………………

10. Name of mother …………………………………………………………………

11. Nationality of mother ……………………………………………………………

I, the undersigned, hereby state that I am/was an Indian citizen otherwise than

by naturalization. I vouch for the correctness of the statements made by me.

Signature …………………………………

Name (in BLOCK LETTERS) ………………………………………………

Full Postal address in Germany ………………………………………………

………………………………………………..

………………………………………………..

Date …………… Telephone Number ………………………………………………

InstructionsThe Declaration, duly filled in & signed by the applicant, may be submitted in person at the Indian Mission/ Consulate on any working day or sent by post, along with following documents:-1. The original Indian passport (or proof that it has already been surrendered to the German authorities.)2. A photocopy of the relevant pages of the Indian passport (laminated pages and address page).3. A photocopy of the Nationality Certificate (Einbuergerungsurkunde), if already issued, or the letter from

the concerned authorities about grant of German Nationality to the applicant.4. Photocopies of the laminated/details pages of the valid German Passport, if already issued.5. Fees [€ 117*] can be paid in Cash at the Mission/Consulate or deposited to its bank account. (Please

see the payment details in the section on OCI)6. Self addressed stamped (for registered post – Euro 3.50) medium size envelope is required for return of

documents unless these are to be collected in person on due date.Note: The general processing time is 1 week. In case a child cannot sign, his/her thumb impression may be provided along with parent’s signature. The consular jurisdiction of this Consulate is States of Bayern & Baden-Württemberg only.

*The fee includes Consular Service Surcharge of € 2 effective from 01.04.2011.= = = = = = = = = = = = = =