Nicop Form - Ministry Of Foreign Affairs
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1
2APPLY NICOP ONLINE AT
National Database and Registration Authority
Ministry of Interior, Government of Pakistan
Instructions
After completion of this
Paste your recent
(a) Read carefully the instructions given at the back before filling the form.
form please mail to:
Fillable Form
photograph
(b) One of the addresses (Present / Permanent) MUST be a Pakistani Address.
Pakistan Consulate
here
(c) Form will be rejected if
marked fields are left blank.
Applicant’s Old NIC No.
NADRA Section
(d) Both English and Urdu fields are compulsory to be filled.
12 East 65th Street
Do not use Pin or Staple
New York, NY 10065
New
1
Type of Application
Duplicate
Change
Surrender
Renewal
Family Head NIC No.
Relation with Family Head
2
3
1.5” x 2”
Applicant’s Full Name
(First, Middle, Last) As you would like it to appear on the card
4
Applicant NIC / CNIC /NICOP No.
5
6
Father’s Name
(First, Middle, Last) As you would like it to appear on the card
7
Father’s NIC / CNIC / NICOP No.
8
9
(First, Middle, Last)
Mother’s Name
10
Mother’s NIC / CNIC / NICOP No.
11
12
Spouse’s Name
(First, Middle, Last) (compulsory for married or widowed)
13
Spouse’s NIC / CNIC / NICOP No.
14
15
( Leave blank if not applicable)
Visible Mark of Identification
16
( Where the Applicant is residing / likely to reside)
Country of Stay Abroad
Date of Birth ( DD / MM / YYYY)
17
18
Pakistani
OR
Foreign Passport No.
Date of Expiry ( DD / MM / YYYY)
19
20
Country of Issue of Passport
21
22
Place of Birth
Present Address
(Preferably Foreign / Otherwise Pakistani)
For Home Delivery Abroad (Extra US$ 7 or equivalent will be charged)
23
Permanent Address
( Pakistani / Foreign Address)
For Home Delivery in Pakistan (Extra Rs. 50 will be charged)
24
Fax No.
Telephone No.
E-mail
(Country Code - City Code - Fax No.)
(Country Code - City Code - Phone No.)
25
In case of state subject of Jammu & Kashmir
26
Migrant from Kashmir Valley
Migrant from Jammu Kashmir or Other areas
Azad Jammu & Kashmir
Applicant’s Signature
Religion
Profession
Education
Gender
Status / Purpose of Stay Abroad
27
Applicant’s Left Thumb
(As it appears on legal documents
Muslim
Business
Post Graduate
Emigrant/Employment Abroad
Male
Engineering
Dual Nationality Holder
Graduate
Christian
Female
Resident/Immigrant Visa Holder
Medicine
Under Graduate
Qadiani
Marital Status
Resident or intending resident
IT
Others
Abroad: (Please tick one of the
Hindu
Married
Management
below)
Gratis NICOP
Parsi
Law
Stude nt Visa
Dependent
Unmarried
Sikh
Labour
Medical Treatment
OPF Member
Divorced
Student
Budhist
Govt. Duty/training
Others
Others
Dependent of above
Widowed
Others
Attester Signature
Mode of Payment
Attester Name
(May be any NICOP
OR
CNIC holder)
Amount
Bank Receipt
28
29
Deposit Date
Bank Draft
31
Attester CNIC / NICOP No.
Bank Receipt / Draft No.
30
Signature or Thumb impression
*
32
I Solemnly affirm that, I believe completely and unconditionally in the finality of the Prophethood of the
Prophet MUHAMMAD (PBUH), and that I am not a follower of any person who claims Prophethood on the
basis of any interpretation of this word, neither I believe such a claimant to be a reformer or a prophet,
nor I belong to Qadiani or Lahori group or call myself Ahmedi.
Prepared By: Machine Readable Passport Section, Consulate
General of Pakistan, New York <mrp@pakistanconsulateny.org>
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