APPLICATION FOR A GUYANA PASSPORT

Republic of GuyanaAPPLICATION FOR A GUYANA PASSPORTFORM ASurname:Maiden Name:First Name:Second Name:Third Name (if any):FOR OFFICIAL USE ONLYP assport No.:_____Dateof issue:_____Indicate whether applicant is:Under 16 years16 and aboveIMPORTANT:READ INSTRUCTIONS CAREFULLY BEFORE COMPLETINGTHIS FORMINSTRUCTIONS ON HOW TO COMPLETE form (A)Males(married or single) and women who havebeenmarried(16years of age or over). Complete Sections 1,2, 6 and 7 if appropriate to their own applications .(B)Married womenof any age (including widows andwomen whose marriage haven t been terminated) arerequired to complete Sections 1, 2, 3, 6 and 7 and ifappropriate to their own applications , section 4.(C)Each person will be issued with their own cases whereeither parent is not available an Affidavitfrom a Justice of Peace or Commissioner of Oaths isrequired. The affidavit must indicate that thechild/children is/are in the custody of either parentmaking the representation to apply and uplift thepassportfor the child/children, or that the applicant is theguardian of the child.

FORM A Lost or Stolen Passport Information Sheet Surname: First Name (s): Gender Male Female Passport number Date of birth Date of issue

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