A F F I D A V I T

I, Mr./Mrs./Miss_______________________________________________________________________________

Son /Daughter/Wife Of__________________________________________________________________________

Born on ________________________________ at ___________________________________________ holder of

Indian Passport No. ______________________ Issued to me on ________________________________________

by the regional Passport oe ______________________________________________________________do hereby

Solemnly declare and affirm that :

1. I  have not acquired Canadian Citizenship or citizenship of any other country,  nor have I changed my Indian Nationality.
             I am still holding Indian Passport while resident in Canada.

2. I  have not gone out of Canada on any travel documents since the expiry of my Indian  Passport No. _____________
    On the __________________________________.

3. I have now applied for Canadian Citizenship which is pending with the local Canadian Authorities.

4. I have not applied for Canadian Citizenship, and have no intention of doing so in the near future.

5. I have not RENEWED/ OBTAINED a new Passport within the prescribed period due to the  following reasons :  

              _________________________________________________________________________________________

              _________________________________________________________________________________________

              _________________________________________________________________________________________


              _________________________________________________________________________________________

                                                                                                                

                                                                                                                                                         

                                                                                                                               Signature of the Applicant

Declared and signed before me in the Province of British Columbia/Alberta/Saskatchewan/Yukon Territory/North West Territories.

Attested :

                                                                                                    Notary Public

Note :Please delete items that are not applicable

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Last Updated: 11/25/2008