Republic of Uganda Ministry of Internal A�airs Directorate of Citizenship and Immigration Control
PASSPORT APPLICATION APPOINTMNENT FORM APPOINTMENT DATE: Print this form and carry it with you together will all attachments to your appointment APPLICATON DETAILS Application Number Serial Number Applicant Name Date Of Birth Telephone Number Email NIN
W000624815 625152 Rwahimu Alimansi May 8, 1998 +27815693240 winertravor@gmail.com CM98008104709H
Signature
Type of Passport Type of Application Priority Place of Submission Place of Collection
Ordinary Lost Express Pretoria Pretoria
PAYMENT DETAILS Bank Name
None
Description
PRN
Amount
Passport Ordinary (48 Pages)
2210006859482
250,000
Fine For Lost Passport
2210006859484
100,000
Fee For Express Processing Of Passport
2210006859485
150,000
Courier Fees For Passports Abroad
2210006859486
10,000
TOTAL PAID
Payment Date
510,000
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RECOMMENDER DETAILS Your recommender must sign and attach a copy of their National ID Recommender Name Profession/Occupation Address NIN Phone Number
KENNETH BWIRE Mathematics Kampala Namanve Uganda CM86042106PYXE +256708536477
Recommender Signature
PASSPORT APPLICATION REQUIREMENTS You must bring along the following supporting documents for your appointment All Applicants • • • •
Uganda National ID Recommendation letter and recommender ID copy Documents supporting your profession Make payments as described in the fees structure
ADDITIONAL ATTACHMENTS Renewal • Old Passport Lost Passport Replacement • A�davit • Police Letter • Payment of �ne of 100,000 Shs for the loss of passport Getting a Passport for a minor (under 18) • • • •
Birth Certi�cate Parents National IDs Any of the parents copy of Passports (Bio Data page and page 45) Letter of consent from the parents
PASSPORT PHOTO PLEASE PASTE DO NOT STAPLE THE PHOTO SHOULD BE COLOURED WITH A WHITE BACKGROUND
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