Blank UK renunciation of British citizenship declaration form, March 2024

UK Visas and Immigration Department 55 Reporting Centre Ground Floor Union Street Liverpool L3 9PP¶

Tel:¶

Please refer to www.gov.uk/contact-ukvi-insideoutside-uk¶

Web: www.gov.uk/uk-visas-immigration¶

Ref:	033972218
Date:	04 March 2024

DECLARATION OF RENUNCIATION¶

This declaration, if signed and sealed, is formal evidence of renunciation of the nationality indicated below by:¶

Place and Country of Birth : Johannesburg, South Africa¶

Nationality : British Citizen¶

The declaration is registered on the understanding that the person named holds another nationality or citizenship or expects to acquire another nationality or citizenship within six months of the date of renunciation. If another nationality or citizenship is not held or is not acquired within six months, this renunciation will not take effect and the person named will be considered to have retained the British nationality (or nationalities) indicated above.¶

For the Secretary of State for the Home Department:¶

Signature¶

Date of renunciation¶