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Saint Christopher (St. Kitts) and Nevis

APPLICATION FOR A PASSPORT

E I\tST[irLrC-rto[\tsHOW TO COMPLETE THE FORM

Sections 1,2,3 and 6 must be completed by all applicants.Sections 4 and 5 are to be completed where.applicable.Section 7 is to be completed by the Parent or Legal Guardian of an applicant under age 16.Section 8 is to be completed by an applicant age 16 and over.Section I is to be completed by the recommender.

DOCUMENTS TO BE PRODUCED

FoR Pensoxs Unoen Ace 161. Completed Application Form2. Two (2) passport sized photos3. Birth Certificate of applicant4. Certificate of Citizenship (if applicable)5. One hundred and fifty dollars ($150.00) fees in stamps6. Old passport (if applicable)7. Passport Recovery Form (if applicable)8. Any other document as may be required

Fon PeRsoHs AcE 16 aruo OveR1. Completed Application Form2. Two (2) passport sized photos3. tsirth Certificate of applicant4. Certificate of Citizenship (if applicable)5. Two hundred and fifty dollars ($250.00) fees in stannps6. Old passport (it applicable)7. Police Record8" Marriage Certificate (if applicant wishes to carry the

sumame of /he spouse)9. Decree Absolute (if applicant wrshes to revefi to maiden

name)10. Passport Recovery Form (if applicable)11. Any other document as may be required

CtrlzeHs gv IHvesrnaenr1. Completed Application Form2. Two (2) passport sized photos3. Birth Certificate of applicant4. Certificate of Citizenship5. Old passport (if applicable)6. Police Record7. Marriage Certificate (if applicant wlshes to carry the

sumame of the spouse)8. Decree Absolute (if applicant wishes to reveft to maiden

name)9. Six hundred and seventy-five dollars ($675.00) fees in

stamps (standad fee)10. One thousand three hundred and fifty dollars ($1,350.00)

fees in starnps (/os{ sto/en or damaged passporf)1 1. Passport Recovery Form (if applicable)12. Any other document as may be required

Damaged Passports - Applicants who wish to replace adamaged passport must complete the Passport RecoveryForm stating the conditions under which the passport wasdamaged. The fee payable is five hundred dollars ($500.00)in stamps.

Lost or Stolen Passports - An affidavit providing details ofthe passport and the conditions under which the passportwas lost or stolen (whether valid or expired), PassportRecovery Form and a police report must be submitted to thePasspo( Office at least one month prior to an application fora new passport. The fee payable is five hundred dollars($500.00) in starnps.

Photographs - Two copies of a recent photograph of theapplicant must be included with the application. Thesephotographs should be taken full face,without a hat on a neutral solid background (no teeth shouldbe showing). Black and white photographsare not acceptable. 'The size of the photografihs is1.77" x 1.38" (45mm x 35mm). The recornmenderis also required to endorse the reverse side ofone copy of the photographs with the words: "l certify thatthis is a true likeness of the applicantMr./Mrs./tvliss(printing the applicant's full name) and add therecommende/s signature and official stamp.

Recommendation - Section 8 should be completed by theperson veriffing the declaration of the applicant" Therecommender should be a Member of the National Assembly,Nevis lsland Assembly, Justice of the Peace, Notary Public,Minister of Religion, Medical or Legal Practitioner, SeniorCivil Servant, Senior Bank Official, Gazetted Police Officer,or any person of similar standing PERSONALLYACQUAINTED with the applicant. Members of lmmediateFamily are not eligible.

To avoid delay answers tosections should be completed in blackor blue ink.

Please fill out the form in BLOCKCAPITALS.

NOTE: Do not sign this form until youhave read all notes on page 1.

a) Applicant'sSignature:

Please sign below within the area bounded by themarks

r- _-l

Lb) Application for:

[ ] Adult

I I Child under Age 16

b) ApplicantsPhotograph:

Supplied photos mustcover the marks below.

2 Surname [ ]Mr [ ]Mrs [ ]Ms [ ]Miss Status: [ ] Single[ ]Manied[ ]Widowed[ ] Divorced

[ ] Legally Separated

Given Names:

Maiden Name: (if applicant is a woman who is or has been manied) Gender: [ ]Male [ ]Female

Has name been changed otherwise than by maniage?lf so, state original name

I lNo I IYes PERSONAL DESCRIPTION

Age last birthday Place and country of birth Date of Birth Height: Feet lnches

Occupation: Colour of eyes

Present address: Colour of hair

Usual place of residence: Special peculiarities (visible):

Contact numbers:

3 CITIZENSHIP

CitizenofSt.KittsandNevisby IlBirth []Descent []Maniage []Residence [ ]Registration []lnvestment

lf born outside of St. Kitts and Nevis, particulars of Certificate of Citizenship/Registration

Number of Certificate Date of lssue ... .. . ..

Daie of Birth

l, the undersigned, declare that the information given in the application is correct and

a. that I have not lost the status of Citizenship of Saint Christopher (St. Kitts) and Nevis

b. that I have not previously held or applied for any passport or

c. that all previous passports granted to me have been cancelled other than passport no. ............... which is now attached andthat I have not made any other application for a passport since lhe attached passport was issued to me.

d. that I understand that knowingly making a false statement in this application is an offence contrary to section 10 of the Passports andTravel Documents Act

Signature

9 RecommenderI certify that the applicant is known to me personally and that to the best of my knowledge and belief, the facts stated

on this form are correct. I have known the applicant for ... ... ... ... ..

Signature

Full name

Occupation

years.

Official stamp

IMPORTANT:- Applicants and persons who countersign applications (see section 7) are warned that, should any statemwith this applicant prove to be untrue, the consequences to them rnay be serious.

3nt made in connection

10 FOR OFFICIAL USE DOCUMENTS SUBMITTED TO BE NOTED HERE

SUPPLEMENTARY INFORMATION