Você está na página 1de 3

FORMA

IRISHNATIONALITYANDCITIZENSHIPACT1956
Declaration,undersection6B(2)oftheIrishNationalityandCitizenshipAct1956,of
residenceintheislandofIreland,itsislandsandseas.
NOTES
1) ThisdeclarationiseffectiveonlyinrespectofperiodsofresidenceinIrelandbytheparentofachild
bornonor after1January2005 asanationalofanEUMemberState,astate(otherthananEUMember
State)thatisacontractingpartytotheEEAAgreementortheSwissConfederation,wheresuch
residenceoccurredinthefouryearperiodimmediatelyprecedingthebirthofthechild.
2) This declarationshould beaccompaniedby thepassport,nationalidentitycard,orcertificateof
nationality,andsuchotherdocumentationasmayberequiredbytheMinisterforForeignAffairs,as
appropriate,relatingtothepersonmakingthedeclaration.
3) Thisdeclarationis NOT requiredinconnectionwiththeentitlementtoIrishcitizenshipofachildborn
before1January2005intheislandofIreland,itsislandsandseas.
4) Thisdeclarationis NOT requiredinconnectionwiththeentitlementtoIrishcitizenshipofachildborn
onorafter1January2005intheislandofIreland,itsislandsandseas,wherethatchildhad, atthetime
ofhisorherbirth, aparent(oradeceasedparent)whowas:
(a) anIrishcitizenorentitledtobeanIrishcitizen
(b) entitledtoresideintheStatewithoutanyrestrictiononhisorherperiodofresidence(includingin
accordancewithapermissiongrantedundersection4oftheImmigrationAct2004)
(c) aBritishcitizenor
(d) entitledundertheimmigrationlawsoftheUnitedKingdomtoresideintheUnitedKingdom(and
thusNorthernIreland)withoutanyrestrictiononhisorherperiodofresidence.
5) Thisdeclarationis NOT appropriate inrelationtothecitizenshipentitlementofachild bornonorafter1
January2005intheislandofIreland,itsislandsandseas,toparentsoneofwhomwas,atthetime ofthe
birth,entitledtodiplomaticimmunityintheState. Forchildrenbornbetween2December1999and31
December2004,thecorrectformofdeclarationisinForms1and2oftheScheduletotheIrish
NationalityandCitizenshipRegulations,2002(S.I.No.567of2002).

I................................................................................................................................. (Name
infull)
of...............................................................................................................................................
.........

(address)
beingoffullageherebydeclarethatIamthe[father][mother]of
........ ......................................(nameofchildinfull) bornat
.....aplaceinthe
islandofIreland,itsislandsandseas,on.(insertdateof
birth)andthat,duringtheperiodoffouryearsimmediatelyprecedingmychildsbirth,I
residedintheislandofIreland,itsislandsandseas,asanationalof (tickasappropriate):
(a)anEUMemberStatenamely....

(b)anEEAmemberstatenamely..

(c)theSwissConfederation

forthefollowingperiod(s):
fromto
fromto
(repeatasnecessary)

Asevidenceofthisnationalityduringtheaboveperiod(s),Iattach (tickasappropriate):
(a)mypassport,or

(b)mynationalidentitydocumentor

(c)acertificateofnationalityissuedbythecompetentauthorityof
mycountryofnationality

Ideclarethattheinformationgivenbymeinthisdeclarationiscorrectandthatthe
accompanyingdocumentsrelatetome.

Signature(Mr./Ms.) ...........................................................................
Date...................................................................
Declaredandsubscribedbeforemea...................................................... (insert
qualification*)bythepersonnamedabovewhoispersonallyknowntome(or,whois
identifiedtomeby......................................................................................whoispersonally
knowntome).
Signature............................................................................
NameinBlockCapitals(Mr./Ms.).
Address
......................................................................................................................................
...................................................................................................................................................
Daytimetelephonenumber.........................
Date ....................................................

IMPORTANTNOTICE
Apersonwhoknowinglyorrecklesslymakes(whetherintheStateoroutsidetheState)afalse
declarationforcitizenshippurposesshallbeguiltyofanoffenceandshallbeliable
(i)onsummaryconvictiontoafinenotexceeding3,000orimprisonmentforatermnot
exceeding12months,ortoboth,or
(ii)onconvictiononindictmenttoafinenotexceeding 50,000orimprisonmentfora
termnotexceeding5years,ortoboth.
*Adeclarationmadeundersection6B(2)oftheActshall
(a) ifmadeintheterritoryoftheState,bemadebeforeoneofthefollowingpersonsrecognisedor
acting assuchwithintheState:
(i)
anotarypublic,
(ii)
acommissionerforoaths,
(iii)
apeacecommissioner,
(iv)
aministerofreligionstatinghisorherdenominationandaddressofplaceof
worship,
(v)
amemberofDilireannorSeanadireannoramemberoftheEuropean
ParliamentforaconstituencywithintheState,
(vi)
amemberofalocalauthorityforthepurposesoftheLocalGovernmentAct2001
(No.37of2001),
(vii)
abarristerorsolicitor,
(viii) aregisteredmedicalpractitionerforthepurposesoftheMedicalPractitioners
Acts1978to2002,or
(ix)
aqualifiedteacherwhoisamemberoftheteachingstaffofaprimaryor
secondaryschoolorathirdlevelinstitution,
(b)

ifmadeinanyplaceotherthantheterritoryoftheState,bemade beforeoneofthe
followingpersons:
(i)
apersontowhomsection5oftheDiplomaticandConsularOfficers(Provision
ofServices)Act1993(No.33of1993)applies,
(ii)
anotarypublic,
(iii)
anypersonwhois,bythelawofthecountryinwhichthedeclarationismade,a
commissionerforoathsorotherpersonauthorisedtotakeaffidavitsandforthat
purposetoadministeroaths.