CITIZENSHIP
QUESTIONNAIRE
All citizenship laws are complex and depend upon births, adoptions, marriages and a wide variety of other events.
Please complete the form below with as much information as is available. It may be completed in Microsoft Word,
or printed out, filled out by hand and scanned (preferably as one PDF file). Then email to info@passportia.org with
“Questionnaire” as the Subject. We try to formulate a view within 2 weeks. If we think that we can get you
citizenship then we send you a quotation. There is no fee or commitment unless you agree to the quote.
We try to discover any possible claim to citizenship, so more information supplied means that more
possibilities can be investigated. This form may be completed on behalf of another person, such as a child,
spouse or parent. The data is confidential. You may leave out names.
If you are unable to provide an exact date, then try to provide the year. Often the year is sufficient at this stage.
Email address:
Phone number/s:
Completed by:
Date:
Citizenship/s of interest: UK / Germany / any EU country / other ________________ (edit or circle as applicable)
I consent to my data being shared with partner firms for assessment for non-UK European citizenships: Yes/No
PERSON TO BE EVALUATED
1
2
Names (optional)
Details of birth
3
Birth registered by government of a country other
than the country where the birth occurred
e.g. through a consulate/embassy
Male / Female
Sex
Date:
Details of marriage of his/her parents
Residency in another country for at least 1 year
e.g. Kenya 1960-1970, Zimbabwe 1970-1987
Country:
Residency (past or present) in the UK or Europe
4
5
7
8
Date:
Country:
Town/Province:
Consulate location:
Government represented:
Date of birth registered:
Country:
Immigration status last held:
Any citizenship/s acquired by application
e.g. naturalisation, registration, or other process
9 Countries that have issued him/her a passport
10 Was he/she ever adopted?
Supply details of any adoptive parent and his/her
parent on an extra form marked “By Adoption”
11 Recent primary occupation/s
12 Any past service for a government, international
organisation or agency e.g. army, navy, air-force,
consular, diplomatic or colonial service, British
Council, Red Cross, UNESCO, United Nations.
13 Number of children born in each period shown
14 Current marital status (delete as appropriate)
15 Details of current/last spouse
©2015 Passportia Limited
Date/s:
Citizenship/s:
Include scans of the documents
Date:
Country:
Government/Organisation:
Service & Rank:
First Year:
Last Year:
On Reserve List: Yes/No
1949-1982:
1983-1996:
1997-now:
Never married / Married / Divorced / Widowed
Date of marriage:
Date of birth:
Place of birth:
Citizenship/s:
Countries lived in:
Ancestors from Europe:
Page 1 of 4
16 If female: details of any man married before 1983
(other than the spouse mentioned above), who was
born in the UK/Europe or ever had a UK/European
passport/nationality or was the child of such a
person.
HUSBAND’s DETAILS Name:
Date of marriage:
Date of birth:
Place of birth:
Citizenship/s:
Ancestors from Europe (which country):
Countries lived in:
FATHER
1
2
Names (optional)
Details of birth
3
4
Born after marriage of his parents
Birth registered by the government of a country
other than the country where the birth occurred
e.g. through a consulate/embassy
5
Each country resident in for at least 1 year. E.g.
Japan 1956-1970, Canada 1971-2014
Date:
Was he ever adopted? If so give details
6
7
Any citizenship/s acquired by application
e.g. naturalisation, registration, or other process
8
9
Countries that issued him a passport
Any past service for a government, international
organisation or agency e.g. army, navy, air-force,
consular, diplomatic or colonial service, British
Council, Red Cross, UNESCO, United Nations, etc.
Date:
Country:
Town/Province:
Yes/No
Date of marriage:
Consulate location:
Government represented:
Date of birth registered:
Country:
Date/s:
Citizenship/s:
Include scans of the documents
Government/Organisation:
Service & Rank:
First Year:
Last Year:
On Reserve List: Yes/No
MOTHER
1
2
Names (optional)
Details of birth
3
4
Born after marriage of her parents
Birth registered by government of a country other
than the country where the birth occurred
e.g. through a consulate/embassy
Each country resident in for at least 1 year. E.g.
Jamaica 1956-1970, United States 1971-2000
Date:
Was she ever adopted? If so give details
5
6
7
Date:
Country:
Town/Province:
Yes/No
Date of marriage:
Consulate location:
Government represented:
Date of birth registered:
Any citizenship/s acquired by application
e.g. naturalisation, registration, or other process
8
9
Countries that issued her a passport
Any past service for a government, international
organisation or agency e.g. army, navy, air-force,
consular, diplomatic or colonial service, British
Council, Red Cross, UNESCO, United Nations, etc.
10 Details of any other man she married before 1983
(not FATHER mentioned above), who was born in
the UK/Europe or ever had a UK/European
passport/nationality or was the child of such a
person.
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Country:
Date/s:
Citizenship/s:
Include scans of the documents
Government/Organisation:
Service & Rank:
First Year:
Last Year:
On Reserve List: Yes/No
EX-HUSBAND’s DETAILS Name:
Date of marriage:
Date of birth:
Place of birth:
Citizenship/s:
Ancestors from Europe (country/s):
Countries lived in:
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FATHER’s FATHER
1
2
Names (optional)
Details of birth
3
Each country resident in for at least 1 year. E.g.
Trinidad 1934-1948, Brazil 1949-2012
Date/s:
Any citizenship/s acquired by application
Citizenship/s:
e.g. naturalisation, registration, or other process
Include scans of the documents
Countries that issued him a passport
Any past service for a government, international Government/Organisation:
organisation or agency e.g. army, navy, air-force, Service & Rank:
First Year:
consular, diplomatic or colonial service, British Last Year:
Council, Red Cross, UNESCO, United Nations, etc. On Reserve List:
4
5
6
Date:
Country:
Town/Province:
FATHER’s MOTHER
1
2
Names (optional) including name at birth
Details of birth
3
Each country resident in for at least 1 year E.g.
India 1934-1948, Kenya 1949-1995
Date/s:
Any citizenship/s acquired by application
Citizenship/s:
e.g. naturalisation, registration, or other process
Include scans of the documents
Countries that issued her a passport
Any past service for a government, international Government/Organisation:
organisation or agency e.g. army, navy, air-force, Service & Rank:
First Year:
consular, diplomatic or colonial service, British Last Year:
Council, Red Cross, UNESCO, United Nations, etc. On Reserve List: Yes/No
Details of any other man married before 1983 (not EX-HUSBAND’s DETAILS Name:
Date of marriage:
FATHER’s FATHER mentioned above), who was
Date of birth:
Place of birth:
born in the UK/Europe or ever had a UK/European Citizenship/s:
passport/nationality or was the child of such a
Ancestors from Europe (country/s):
Countries lived in:
person.
4
5
6
7
Date:
Country:
Town/Province:
MOTHER’s FATHER
1
2
Names (optional)
Details of birth
3
Each country resident in for at least 1 year. E.g.
Malta 1934-1948, Egypt 1949-2001
Date/s:
Any citizenship/s acquired by application
Citizenship/s:
e.g. naturalisation, registration, or other process
Include scans of the documents
Countries that issued him a passport
Any past service for a government, international Government/Organisation:
organisation or agency e.g. army, navy, air-force, Service & Rank:
First Year:
consular, diplomatic or colonial service, British Last Year:
Council, Red Cross, UNESCO, United Nations, etc. On Reserve List: Yes/No
4
5
6
Date:
Country:
Town/Province:
MOTHER’s MOTHER
1
2
Names (optional) including name at birth
Details of birth
3
Each country resident in for at least 1 year. E.g.
Swaziland 1934-1948, South Africa 1949-1998
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Date:
Country:
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Town/Province:
Page 3 of 4
4
Any citizenship/s acquired by application
e.g. naturalisation, registration, or other process
5
6
Countries that issued her a passport
Any past service for a government, international
organisation or agency e.g. army, navy, air-force,
consular, diplomatic or colonial service, British
Council, Red Cross, UNESCO, United Nations, etc.
Details of any other man married before 1983 (not
MOTHER’s FATHER mentioned above), who was
born in the UK/Europe or ever had a UK/European
passport/nationality or was the child of such a
person.
7
Date/s:
Citizenship/s:
Include scans of the documents
Government/Organisation:
Service & Rank:
First Year:
Last Year:
On Reserve List: Yes/No
EX-HUSBAND’s DETAILS Name:
Date of marriage:
Date of birth:
Place of birth:
Citizenship/s:
Ancestors from Europe (country/s):
Countries lived in:
ANY REMOTER ANCESTOR BORN OR NATURALISED IN GERMANY,
POLAND, ITALY, SPAIN or PORTUGAL?
Provide information on the last ancestor born or naturalised in the European country concerned:
Sex
Date
Country,
Date of
Religion
Line of
Any other information?
of
province and
emigration
at time of
descent
birth
town of birth or
from country
emigration
Male/
e.g. passport, nationality or
identity documents of ancestor
naturalisation
of birth or
Female/
naturalisation
Mixed
M/F
PLEASE SUPPLY SCANS OF ANY:
BRITISH or EUROPEAN PASSPORTS (include front cover and first 4 pages, including photo page)
Documents relating to CITIZENSHIP or NATIONALITY (naturalisation, registration, declaration, oath of
allegiance, renunciation, certificates, official letters, etc.)
PLEASE WRITE BELOW ANY OTHER INFORMATION WHICH YOU THINK MIGHT BE RELEVANT
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