The father is not a Namibian citizen. Slate whether he is a permanent resident of the RepllbHc otNamibia: No D I f'ves, state Perrnanenl Residence Permit Number (not number of form)
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online from Scribd
Late Registration of Birth - Namibian Home Affairs Form
The father is not a Namibian citizen. Slate whether he is a permanent resident of the RepllbHc otNamibia: No D I f'ves, state Perrnanenl Residence Permit Number (not number of form)
The father is not a Namibian citizen. Slate whether he is a permanent resident of the RepllbHc otNamibia: No D I f'ves, state Perrnanenl Residence Permit Number (not number of form)
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
0 ratings0% found this document useful (0 votes)
410 views6 pages
Late Registration of Birth - Namibian Home Affairs Form
The father is not a Namibian citizen. Slate whether he is a permanent resident of the RepllbHc otNamibia: No D I f'ves, state Perrnanenl Residence Permit Number (not number of form)
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
You are on page 1of 6
1-D r 0031
MINISTRY OF H'O'ME AFFAIRS
D'EPAR. E -T 'OF' CIVIC AFFIRS
APPLICATION FOR THE LATE RE'GISTRATIO ,O'F A BIRTH
WARNING: rAE PENALTIE FOI~F'LSE STt\TEME T'WlLLFUl.t.Y MAD'E R - 1-1 S ~'1E! AS THOi -t: fOR PKRJR~·.
2. All i~cm5 lnUSl be completed in detail. s\ m~~ d:.'l.~h i not acceptable
3. Failure W ,·oI.H.nplete i'll detatl \lorill c.::m!iC J..1l:u:mces..'W)' delay,
4. The :.('Imp~etcrl form must be ron"'a:rooo to nhr·lJl1der·Secn~IiJ:IJ', Department or Ci .. tc Afri~ hs, rl'iv01te oo~ I nO)" \V:mdhoeJ,. Nalnlbj tI
.PAR'T)CUL ,,;ItS OF THE APPUCANT
Surname:
M"~rnNilln~tlf~rlk~Ncr _
Fir.sl Names (in full): _
Pf.lrw:ubrs of bmh:
lu) Dale nr birth: ~~
~ h f Place L~f birtlr, ----:::-::----::- -,-- .
(Di<.trkl) (COUr1try I
r ,-=£-:I,"-"\-I....[1""T; I ~I
MALF ~
!. Mariud, l>lalw .. IllldkHle by means ul':m "X" whatever 11' apphcable and auach bOP)' 01. marnaue ceni!'l,c,uc)
Slt1gl,1.: c=J Mnrned c=J \Vil1.dow,,~ri.Fldowd[:::::::=J Scpl!r::ltctl CJ Di\>'t1r(,;<.~u c=J "'H scpcrnted .. ~t!~te whether tb\'or~c proceedmgs have beeu instinncd nrul W'ht~11 final Ji\'urLL.: h C'X.PC'L,;iJ.:J:
Idtntily nUJll~~ (irHV~IHh~c)~ ~~ __ ~~~ ~
I, Passport or other travel document:
c:.) Number: tblDmenfc.xpiry _
fL') Issuing Authority (all;,u.:b document) ~ _
(d) N<lt~lJmtl.ily: _
~e} Immigration Perm.i.l ~umber?: In Date ofissiW; _
Particu I ars of r~s i den ce inN arm hI (I j iran y): t h not, eopmlete paragraph I J )
fa,l dare of entry: ~
(hI Posta] aduressin Namibia: . _
Ie) Re s ideruial Address _
_______________________ Telephone Number, _
h;l) If you UTe alreadyworking :\amihia_ nr on a visit, state numberand date of your temporary residence permit
h;)II' you have no permit explain circumstances uruter which you Jim) yourself in Namibia;
10. (a, I r married. state full name of spouse ~inc~udil1~ nun den name. where applicable J: _
t b) P lace and dale or hi rth uf ~ ["II 11.1 'i.e .
(,) Ni:!h1 re ami address of employer of SPOLI~C llf cmploy~d~· ~ ~_
\
Q.. r; -..iiI' -
- .... -. -.
-,
;. Ii ~ :;
'" 11 ~ 3,
a s z,
R ~ "'''
;:.. ~ po
.... ~ ~
~ a
... ~ ""
'" ~ Q.
" a.
::r ::t' ~ ~
~ "=' n
-.:: 1 I";: 0
'iii'! ~ "1;]'
z; ~ '--=
- ~ ~
;:,", - F
:::l E'- ::T
~ ~ ~ :t
11 0 e
';7 ~ 1..'
~ ~tI
" -.;;l e. r,
..., n
.2. ~ W 2-
t;.. t (..
:::: :r ~'
'=< e-,
? lJii "' i\
'," ~
5 =:l'J
U r:
>: !."
e Fe
R ~
-
'"
!; ;E.
L~ l
~
e, n
5 5ij
<"I
g n
~ ~,
~ ~'
r'!>
;:J I»
~
P'l r.
:::l ,~
a
~ :s::
I!':... '"
n ~.
-; ...
G ::-t-
...,
&.
-=
~
I"l
r:
~,
"
",
~
"::l
('.
r,
.~
F o.c;- c.;; --J I:J" !.l!o ,;:;. - r·~ ~
:J..
;;:: o: C! , :;,; " :=: til ~
- ..., <=
:ill <'I § ~ ~ r. ::!
::L ~ N :!,;. ... ~. ~
:~ i!'O -5 ~ t; ::=: ~ F.
i:;!' :: :;; ~
;~!~ 5 ~ ~ ... ;;:I , ......
'Jl =.. .. ~ " § r ...
~ .5 i ... i: -
1'1 -:j _, 3 -:; ~
... ? ~ :r ;;;; =
.. ;l ~ ~ - ~
:z s Go ~ II' "2-
" ~ "0' ;r
'" ~ - - ~
:t '7. P . ...., ~
I 1 r n I:;, sa
~' ~I Q. ~. '''0 r,
2 2 p
3. 'l 2:
EI :::l
.. r:r ..., 1"1
<I I" ... g.
e, s
=- ti' .;;,.,