EFTA00037130

UK Visas & Immigration 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: Date: 033972218 04 March 2024 DECLARATION OF RENUNCIATION This declaration, if signed and sealed, is formal evidence of renunciation of the nationality indicated below by: Name : Date of Birth N "‘1111 .. r) 1 pi n' —' et '1 (43 1 • .. , 1.',/i. . ,, , 4 ,,- L i (A . {.r,..J % 1 , „> . Ai tl 1 . t,,,. ;1 ..„ 1, (A ..,-1,t ,, . e;' 4 . ii ' • () t: 1 qii //,', filliltkl 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. EFTA00037130