DECLARATION FORM A). DECLARATION Lo of Omang /ID No: __ __ of Ward Village residing at _ do hereby take an oath and declare the following (Tick in the box to confirm) i. Lam single/married/widowed/divorced. ii Tam over 18 years of age. | iii, Ido not own any residential plot anywhere in Botswana. Oo iv. Thave never owned any residential plot anywhere in Botswana. v. My Spouse does not own a residential plot anywhere in Botswana. vi. My Spouse has never owned a residential plot anywhere in Botswana B). CONDITIONS OF THE WAITING LIST i. If the Land Board discovers that I applied while I was under the age of 18 years, Iwill not be enrolled in the waiting list ii. If I falsely apply for the deceased person, severe penalties will be imposed. ili, If I forge another person's signature, serious punishment will be taken against me. I make the above declaration consciously trusting the same to be true and if it is found to be untrue I will be liable before court of law. Signature: Date:REPUBLIC OF BOTSWANA APPLICATION FOR CUSTOMARY LAND RIGHTS Full names of applicant 2. Postal Address. 5 Tet-No. 3. Date of Birth: es 4. ABR mmc 5. Man/Woman* 6. Are you citizen of Botswana? YesiNo* ID No. 7. Marital Status: Married/Single/Divorced/Separated Widowed.* 8. If' married, name of spouse 9. Name of place where plot applied f0F i8 nnn 10. Present use of the plot applied for 11. Size of plot applied for 12. Proposed use: (a) residential (b) ploughing (cemetery (d) Others: specify 13, Is the site applied for debushed. YesiNo* 14. List in full the names of people whom you have consulted who hold land bordering the plot for which you are applying ... 15. List any other land rights you possess anywhere in the Country. 16, Areall the sites mentioned above developed? YesiNo* Ifno give reasons “Delete words which do not apply