BAHAMAS PASSPORT APPLICATION FORM

1 2. CONTACT DETAILS:5. PASSPORT DETAILS (only for previous PASSPORT holders) :4. FAMILY DETAILS:3. EMPLOYMENT DETAILS:1. PERSONAL DETAILS: Mr. p Mrs. p Ms. p Miss. p Dr. p Other _____ BAHAMAS PASSPORT APPLICATION form (To be completed in BOLD CAPS and Black or Blue Ink)(For Official Use Only) APPLICATION ID: _____Ordinary/Regular p Child p Frequent Traveler p Certificate of Identity p Diplomatic p Official pFirst Time p Renewal p Damaged/Lost/Stolen pSurnameFirst NameMiddle Name(s)Maiden SurnamePlace and Country of BirthDate of Birth (DD/MM/YYYY)Height_____ ft. _____ of EyesColour of HairNationalityVisible Identification Marks (Please note in detail)National Insurance Male Female p pPresent Address (Apt. No., P O Box, Street, City State & Country)Permanent Address (Apt. No., P O Box, Street, City State & Country)Telephone (Home & Work)Email (Optional)OccupationEmployer Name, Address, and Telephone ( If applicable)Father s Full Name (underline surname)Mother s Full Name (underline surname)Spouse s Full Name (underline surname)Country of BirthCountry of BirthCountry of BirthNationalityNationalityNationalityDa te of Birth (DD/MM/YYYY)Date of Birth (DD/MM/YYYY)Date of Birth (DD/MM/YYYY)Person to contact in case of an emergencyName: Address:Relationship: Telephone.

2 Bearer s name at time of issue of previous passportPassport NumberStatus of PASSPORT Expired Pages Full Name Change p p p Damaged Stolen Lost p p pDate Lost/Stolen (DD/MM/YYYY)Place (Island/State/County/Province) &Country where lost/stolenPolice Report Yes No Submitted p pPolice Station & Date of ReportHas loss been Yes No Reported to Police? p p6. ADDITIONAL DETAILS: 10. COUNTERSIGNATURE (Required for First Time and Lost or Stolen applications only) :9. DECLARATION OF APPLICANT:8. TO BE COMPLETED IF CHILD IS UNDER AGE 18:7. TO BE COMPLETED IF PERSONS BORN ABROAD: BAHAMAS PASSPORT APPLICATION form (To be completed in BOLD CAPS and Black or Blue Ink)Applicant a Citizen of the BAHAMAS by: Birth Registration Naturalization p p pDocument NumberDate of Document Issue (DD/MM/YYYY)What other names have you used?

3 (list all alias)1 _____ 2 _____3 _____ 4 _____Mother is a Citizen of the BAHAMAS by: Birth Registration Naturalization p p pDocument NumberPresent Address (including country)Full Name (mother, if unmarried, either parent, if married or legal guardian)Place of Document IssueApplicant a Citizen of the BAHAMAS by:Marriage Adoption Poll Deed p p pOther: _____Father is a Citizen of the BAHAMAS by: Birth Registration Naturalization p p pPlace of Document IssueDocument NumberPlace of Document IssueDate of Document Issue (DD/MM/YYYY)Date of Document Issue (DD/MM/YYYY)Registration Certificate NumberDate of Registration (DD/MM/YYYY)If applicant s birth was registered at a Bahamian Consulate abroad, state the citywhere the Consulate is to ChildI hereby give my consent for (name of applicant) to be issued a passportDate (DD/MM/YYYY)SignatureI, the undersigned, hereby apply for the issue of a PASSPORT .

4 I declare that the information given in this APPLICATION is correct to the best of my knowledge and belief, that I have the status of Bahamian citizen, and that I have not renounced citizenship of The BAHAMAS . I further declare that: p I have not previously held or applied for a PASSPORT of any description. p All previous passports granted to me have been surrendered, other than PASSPORT of document No. _____ which is now attached, and that I have submitted no other APPLICATION for a PASSPORT since the attached PASSPORT or travel document was issued to :_____ Date:_____Full Name (please print)Present Address (including country)I certify that the applicant has been known personally to me for _____ years and that to the best of my knowledge and belief the facts stated on this form are correct. I am a citizen of _____ and I was born at _____SignatureDate (DD/MM/YYYY)ProfessionOFFICE STAMP