* delete whichever is not applicable.
Reg. No. _____________________ Surname _____________________ Other names _____________________ Date of birth ____________________________Sex ____________________ Born in___________Gombolola ___________________County _____________ National Identification Number or Alien Identification Number of child ____ Name of father* __________________________________________________ Nationality of father*______________________________________________ National Identification Number or Alien Identification Number of father____ Name of mother __________________________________________________ Nationality of mother* ____________________________________________ National Identification Number or Alien Identification Number of mother ____
Issued on _______________________, 20 ____
By_____________________________________________________________ Registration Officer
*This certificate is not conclusive proof of the paternity of the child or of the nationality either of the father, mother or the child.
NOTICE OF INTENTION OF CHANGE OF NAME OF ADULT
Notice is given that I, ______________________________, is intending to apply to the Authority to change my name to ________________________________. I intend to formally and absolutely renounce and abandon the use of the name _________________________________ and assume and adopt in place of that/ those name(s) the name of _________________________________________
Signed/Thumb marked __________________________________________ at ____________________________________________ this ______ day of _______________, 20 ____.
____________________________ Signature of Applicant
To: The National Identification and Registration Authority,
Application to Change a Name of CHILD.
Notice is given that I, _______________________________________, formerly called and known by the name of __________________________, give public notice that on the ______ day of _______________, 20____, I formally and absolutely renounced and abandoned the use of my former name(s) of ______________________________ and assumed and adopted in place of that/ those name(s) the name of ___________________
This is to request that the Register be updated accordingly.
Signed/Thumb marked ____________________ at ______________________
this _____ day of _____________________, 20 ____.
_____________________________ Signature of Applicant
Application to Change Name of a Child.
To: The National Identification and Registration Authority,
I/We, _______________________ of ______________________ (parish), in the subcounty of ____________________,_________________ county _________________ in the district of _______________________ being the parent(s)/guardian(s) include national identification number)* of a child named ____________________, aged ________, apply that the name of___________________________ be changed to that of __________________ __________________ as from the ______ day of _______________, 20 ____.
Signed/Thumb marked __________________________ at ________________ _____________________ this ______ day of _______________, 20 ____.
In the presence of ________________________________________________
____________________ _____________ * delete whichever is not applicable.
APPLICATION TO UPDATE REGISTER AFTER OPERATION OF HERMAPHRODITE
To: The National Identification and Registration Authority,
I ………………. (name) of…………………(address), National Identification Number/ Alien Identification Number……………being the parent or guardian* of ……………..(name of child) aged………………years, National Identification Number…………………………previously registered as a…………………… (state sex), having undergone a successful operation, apply that the Register be updated with the following details-
Name………………………………………………………… (state new name)
Sex…………………………………………………. (state sex after operation).
Dated at……………….this……………………day of……………..20…….
Signed by………………………………..………... applicant
In the presence of…………………………………. witness.
The Registration of Persons (Births and Deaths) Regulations, 2015
Deaths in the subcounty/city/municipality/township/hospital of ______________________________________ county of ______________________________ in the district of ______________________________________
Full name, occupation National and Identification Whether cause of residence Signature Date and Cause When Signature Place of Address and Number/ death medically of declarant of No. time of Full name Age Sex Nationality of registered of person death occupation Alien certified- Yes/No and in what registration death death registering Identification capacity he officer Number or she gives information
The Registration of Persons (Births and Deaths) Regulations, 2015 Monthly Return of Deaths.
Return of death in the subcounty/city/municipality/township of ___________________________________ county of __________________ in the district of ___________________for the month of _________20……… Full name, occupation Whether and National cause of residence Date Identification Cause death When Signature of Place of Full Address and of declarant Page No. and time Age Sex No./Alien Nationality of medically regi- registration death name occupation and in what of death Identification death certified- stered officer capacity he No. yes/no or she gives information
I, _________________________________, registration officer of ___________________________subcounty/ city/municipality/township, district of ___________________________________________________________, certify that this is a true copy of the Register of Deaths within that subcounty/city/municipality/township/hospital, from the entry of the death of __________________________________ No. ________ to the entry of the death of _______________No. ________ and that it contains a copy of the entry of all deaths registered in that subcounty/city/ municipality/township/hospital for the month of _______________, 20 ____. Witness my hand, this ______ day of _________, 20 ____ ________________________ Registration officer
Application to Register presumed death
I …………….(name of applicant) of……………(address), National Identification Number/ Alien Identification Number……………being the parent or next of kin (state relationship with the person presumed dead) of ……………………..(name of person presumed dead) aged………………years, National Identification Number…………………………, apply to register a presumption of death order No……dated………….day………..of………….(attach copy of order).
Dated at……………….this……………………day of……………..20…….
Signed by……………………………………………………………..applicant
In the presence of……………………………………………………….witness.