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Unformatted text preview: burned passports, police report required. ___________________________________ __________________ ___________________  Cancelled & Returned  Attached Name in which issued Passport Number Issuance Date DO NOT SIGN APPLICATION UNTIL REQUESTED TO DO SO BY AN AUTHORIZED OATH-ADMINISTERING OFFICIAL OATH AND SIGNATURE : I have not, since acquiring Palau citizenship, been naturalized as a citizen of a foreign state other than the United States; taken oath, or made affirmation or other formal declaration of allegiance to a foreign state (other than the United States); accepted or performed the duties of any office, post, or employment under the Government of a foreign state or political subdivision thereof (other than the United States); made a formal renunciation of nationality. I disclaim nationality in any state or country other than the Republic of Palau and the United States, that may have accrued to me through the nationality of my parents or for any other reason whatsoever and I hereby renounce absolutely and entirely all allegiance and fidelity to any foreign province...
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