APPLICATION FOR A GRENADIAN PASSPORT

1 APPLICATION FOR A GRENADIAN PASSPORTP lease read the following instructions carefully before completing the TO COMPLETE THE FORM All relevant sections must be completed by all applicants. Answers should be clearly written in the applicant's own handwriting orparent's/guardians in the case of persons under 16 years of age, using penand block THE FORMThe PASSPORT Holder must sign the form in the space provided above section1 and in section 11. For children under 16 yrs. the parent(s) or Guardian(s) mustsign section 11 only.

2 Section 12 should be completed by the person verifying thedeclaration who should be a member of Parliament, Justice of the Peace,Minister of Religion, Medical or Legal Practitioner, Established Civil Servant,Principal and other qualified Teachers, Bank Official, Police Officers from therank of Inspector or any person of similar standing personally acquainted withthe member of the applicant's immediate family is not acceptable as arecommender. The recommender must be a Citizen of TO BE PRODUCED(A) Any person who surrenders with this APPLICATION a previous machinereadable PASSPORT establishing his/her identity and nationality will not normallybe required to produce any other documents unless the person s name or statushas been changed.

3 (B) Males (married or single) and female who have not been married andchildren should produce birth certificate or certificate of naturalization orregistration as a citizen of Grenada as the case may require.(C) Married women (including widows and women whose marriage have beenterminated) should produce marriage certificate or divorce certificate whereapplicable.(D) If the person has changed his or her name, the registered birth certificate ordeed poll recording the change must also be submitted.(E) All documents submitted such as birth, marriage, divorce, registrationcertificates and deed poll must be in its original form with a photo copy.

4 (F) Photographs. Two copies of a recent photograph (not more than six months)of the applicant or of a child under the age of sixteen (16) must be included withthe APPLICATION . These portraits must be taken full face without hat or head bands,the portrait shall show the applicant looking directly at the camera. It should haveappropriate brightness and contrast if in colour, it should show skin tonesnaturally. The size of the photographs shall not be longer than 45x35mm( ) nor smaller than 32x26mm ( ) in height and width.

5 Theportraits must be printed on normal thin photographic paper and must not beglazed on the reverse side. The recommender is also required to endorse thereverse side of one copy of the portrait with the words: I certify that this is a truelikeness of the holder Mr. /( .. and add his nationals in the Diaspora with a lost damage or stolen PASSPORT must makeapplication for replacement at any one of the nearest embassy/consulate/Missionoffice in the country of UNDER THE AGE OF 16 YRS. may not be granted a passportwithout the written consent of the legal guardian the father, or if the father isdead, the mother or in the case of a child born out of wedlock the mother.)

6 If thefather and mother are dead, a written consent from the person who has legalcustody of the child must be submitted. Proof of legal custody must be CONTACTIt is important to provide information on the person who may be contacted in theevent of an PRINT YOUR ANSWERS IN THE SPACES BELOW WHERE of PASSPORT Holder in the middle of the space provided.+ , X. -Note: Leave this space blank if applying for a PASSPORT for a person unable to sign.

7 Marital Status:GSingleGMarriedGDivorcedGWidowedG Re-marriedGSeparatedSURNAME:(in block capitals)CHRISTIAN NAME(S):MAIDEN NAME:If name has been changed other than by marriage, state original of Birth (dd\mm\yyyy)../../..Place of Birth: Age last Birthday: Colour of Eyes Special Peculiarities (Visible) Colour of HairCountry of ResidencePresent Address Permanent Address Telephone Fax MARRIED, DIVORCED, SEPARATED OR WIDOWED GIVE INFORMATION ON SPOUSE OR FORMER Name:Middle Name:Maiden NameDate of Marriage(dd\mm\yyyy).

8 /../..Place of MarriageCountry of BirthNationalityProfession or OccupationState whether married more than once .. If more thanonce, particulars of previous marriage or marriages should begiven in Section 10 page AddressMailing AddressTelephone Home: Business Fax: of ParentsFather First Name Middle Name Surname Date of BirthPlace of BirthMother Name First Name Middle Name Surname Maiden NameDate of BirthPlace of BirthPlace of MarriageDate of MarriageCountry of OF PASSPORT HOLDERC itizen of Grenada by.

9 G BirthG DescentG NaturalizationG RegistrationG InvestmentIf citizen of Grenada by Descent attach birth certificate of parents(s) to establish parental claim. If citizen of Grenada by naturalization, registration orinvestment give particulars of registration or naturalization certificate and attach a certified copy of sameType of CertificateCertificate of IssuePlace of born in any foreign country must complete particulars of parent(s)If born in Grenada attach Birth certificateName:Place of BirthDate of BirthIf Citizen of Grenada by naturalizationRegistration or InvestmentType of CertificateCertificate NumberDate of IssuePlace of REQUIRED FOR TRAVELLING TO.

10 PURPOSE OF of previous PASSPORT which has been lost or is not available for present : A police report must be submitted with the APPLICATION , together with proof of NumberDate of Issue (dd\mm\yyyy)Place of IssueBearer s full name at time of issuePlace of lossDate of loss (dd\mm\yyyy)What measures were taken at time to report loss and to obtain recovery?How did lost occur?Has loss been reported to the Police? (If yes, attach copy of police report) IN CASE OF EMERGENCYS urname:Christian Name(s)TelephoneFaxE-mailAddress: S CONSENT (See note on page 1)I (name).