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MAOMBI YA KUTAKA PASI YA KENYA KWA AJILI YA MTOTO MWENYE UMRI WA CHINI YA MIAKA 16 APPLICATION FOR A KENYA PASSPORT FOR A CHILD UNDER SIXTEEN YEARS OF AGE Fomu ijazwe na mzazi au mlezi wa halali au ijazwe kwa idhini ya mzazi au mlezi wa halali To be completed by or with the written consent of the legal guardian (Tafadhari soma sana maelezo kabla ya kujaza fomu) (Please read the instructions carefully before completing the form) 1. Nmna ya kujaza fomu: sehemu No. 1, 2, 4 na 5 ni lazima zijazwe 1. How to complete form: Sections 1, 2, 4 and 5 of this form must Sehemu No. 3 ijazwe iwapo majina ya watoto wengine yatakiwa Section 3 must also be completed if other children are to be en- 2. iwapo jina la mtoto lilikuwamo katika pasi ingine, pasi hiyo ita- 2. If the child’s name has previously appeared on another person’s passport that passport must be produced. 3. Kukubaliwa kwa maombi: katika fungu la 6 maombi lazima yaku- 3. Recommendation of application: The application must be recom- baliwe na mwananchi wa Kenya kama Mkuu wa dini, daktari, wakili, mended in section 6 by a citizen of Kenya, such as a Minister of mtumishi wa serikali mwenye cheo au mfanyi kazi wa benki Religion, a medical or Legal Practitioner, an established Civil Ser- vant or Bank Official personally aquainted with the applicant. 4. Picha: picha mbili za mwombaji ambazo zimepigwa karibuni 4. Photographs: two copies of a recent photograph of the applicant zitatakiwa pamoja na fomu ya maombi. Picha ni lazime ziwe zaonye- must be included with the application. These photographs must be sha sura kamili bila ya kofia kichani tena zisiwe juu ya karatasi taken full face without hat, and the photographs must not be ngumu. Picha zisizidi urefu wa urefu wa inchi 21/ mounted. The size of the photograph must not be more than 21/ 2 na zisipungue urefu wa inchi 2 na upana wa inchi 11/ inches by 2 inches or less than 2 inches by 11/ za karatasi yake maalum ya picha wala zisipakwe dawa ya kung’ar- graphs must be printed on normal thin photographic paper and must isha kwa nyuma. Mkubaliaji atatakiwa aandike nyuma ya picha moja not be glazed on the reverse side. The recommender is also required to endorse the reverse side of one copy of the photograph with the ……………………….” atie na sahihi yake. ……………………….” and add his signature. 5. Ada ya pasi ni Sh. 100 na ada hii yatakiwa kwa noti au shilingi au pesa za posta ziitwazo “ Postal Order”. Cheki hazikubaliwi. 5. The fee for a passport is Sh. 100. this fee must be paid in cash or crossed Postal Order. Cheques are not accepted. 6. Maombi ya pasi ofisini ya kutoa pasi yaani Passport Control Of- fice, P.O.Box 30191, Nairobi au Mombasa yaani Branch Passport 6. Application for a passport must be submitted to the Passport Control Office, P.O.Box 90284, Mombasa. Maombi yapelekwe kwa Control Office, P.O.Box 30191, Nairobi or to the Branch Control muda usiopungua siku 14 kabla ya mtoto kutaka kusafiri. Office, P.O.Box 90284, Mombasa, at least 14 days before the child 7. pasi haiwezi kutolewa au kukubaliwa tena na ofisa wa passport kwa mtu aliyenje ya Kenya. Watu kama hao inawalazimu wafikishe 7. A passport cannot be issued or renewed by the Passport Control maombi yao kwa Kenya Consulate Office ya High Commissioner au Officer no behalf of a person already abroad. Such persons should ambapo hapana mwakilishi wa Kenya, wafikishe maombi kwa apply to the nearest Kenya consulate, office of a Kenya High Com- missioner or where there is no Kenya representative to the nearest Pasi hazitolewi nje ya Kenya kwa njia ya Posta. Passports are not sent out of Kenya by post. 8. Mwombaji atakiwa aonyeshe hati ya ushuhuda ya uananchi. 8. Documentary evidence must be produced to support claims to 9. Iwapo mama au mtu mwingine anadai kuwa yeye ni mlezi wa halali wa mtoto, hali baba yake mtoto yu hai, basi ni lazima aonyeshe ushuhuda wa amri ya korti uliomruhusu mtoto awe chini ya ulezi 9. The mother or any other other person claiming, during the life- time of the father, to be the legal guardian must produce the Court Order commiting the child to her or that persons custody. 10. Hati ya kuonyesha siku ya kuzaliwa inaweza kupatikana kutoka katika Ofisi ya Registrar-General, P.O.Box 30031, Nairobi au kutoka 10. Kenya birth certificate may be obtained from the Registar- kwa Assistant Registrar, P.O.Box 80366, Mombasa. General, P.O.Box 30031, Nairobi or Assistant Registrar, Box Iwapo Jina Limebadirishwa Taja la Zamani If Name has Been Changed State Original Name (3). Majina ya watoto wengine wenye umri wa chini ya miaka 16 yaingizwe katika pasi Other children under 16 to be included in the passport. (4). Jina la Baba na mahali alipozaliwa } Countries for which passport is to be endorsed Mimi niliye tia sahihi yangu hapa chini naomba mtoto aliyetajwa hapo juu apewe pasi. Najulisha: (a) Kwamba maelezo yangu yaliomo katika fomu hii ni ya kweli kama nijuavyo na kuamini. (b) Kwamba mtoto hajapoteza haki za uananchi wa Kenya . (c) Kwamba mtoto hakuwa na pasi yo yote zamani wala kupeleka maombi ya pasi. au (d) Kwamba vyeti vyote vya kusafiri vya zamani alivyopewa huyu mtoto vimerudishwa isipokuwa pasi/cheti cha kusafiria No…………………….ambayo/ambacho (k)ipamoja na fomu hii ya maombi. Tena sijapeleka maombi mengine ya pasi tangu mtoto apewe pasi hii/cheti cha kusafiri hiki. (Futa yasiyohusu kati ya “C” au “D” hapo juu) I, the undersigned, hereby apply for issue of a passport to the above-named child, I declare: (a) That the information given in the application is correct to the best of my knowledge and belief. (b) That the child has not lost the status of Citizen of Kenya. (c) That the child has not previously held or applied for a passport of any description. (d) That all previous travel documents granted to the child have been surrendered other than passport or travel document No…………………….which is now attached. And that no other application for a passport has been made since the attached was issued to him/her. (Delete “C” or “D” whichever is inapplicable) (6) MKUBALIAJI (Tazama maelezo ya kujaza No. 3) Mimi nakubali kuwa mwombaji ni mtu nimjuaye na kama nijuavyo na kuamini maelezo yake katika fomu hii ni ya kweli. Mimi ni mwnanchi wa Kenya. I certify the applicant is personally known to me and that to the best of my knowledge and belief, the facts stated on this form are correct. I am a citizen of Kenya. Sahihi……………………………………………………………………….Tarehe…………………………………. Signature…………………………………………………………………….Date……………………………………. Kazi……………………………………………………………………………………………………………………. Profession………………………………………………………………………………………………………………. Anwani…………………………………………………………………………………………………………………. Address…………………………………………………………………………………………………………………. Jambo Muhimu: Waombaji na wakubaliaji wahadhariswa kuwa waweza kuingia matatani iwapo maelezo yao yo yote yaliomo katika katika fomu hii yatadhibitishwa kuwa si ya kweli. Important: Applicants and Recommenders are warned that should any statement made in connection with this application prove to be untrue, the consequences to them may be serious. Passport No. …………………………………. Issued on. ……………………………………. Serial No. ……………………………………. Remarks and instructions of appointing officer: Signed………………………………….

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