(Sumame) (Christian Names or other Names) NATIONAL REGISTRATION NUMBER: For Official Use FORM A APPLICATION FOR A BARBADOS PASSPORT for Persons over Sixteen years of age IMPORTANT: Read Instructions carefully before completing this form. NOTES HOW TO COMPLETE FORM 4 DOCUMENTS TO BE PRODUCED 1. Sections 1, 3, §, 8,and 11 on this form must be (a) the applicantwas bom in Barbados ~ applicant's Birth Cartfcate, completed by all applicants for new passports. In cases where the name Is not included on Birth Certitcate, Baptismal Gertifcate must be also produced Section 2 must also be completed by those to whom ‘ Pe Beecetonsenbs (©) Persons bom outside Barbados — Section Tmustbe completed ifthe applicant’ children Under 18 are to be inouded nthe passport. The same documentation Is required as for separate passports (See note 4) It must be noted that any person born outside of Barbados may not be issued with a Barbados Passport unless he Is recognized or registered as a Citizen of Barbados by tho Ministry. ‘The form should be clearly writen in applicant's own (Citizenship by descent - Letter of recognition as Citizen of handing using BLOCK CAPITALSr all names. Barbadosi(Certicate of Citizenship ‘A new passport is required by @ woman on marriage o t izationor The propria verde ease ee ual pall (i) Citizenship by Naturalization or Registration -The appropiate Registration Certificate, CChidren over 16 years of age may not be included in ‘an aduls passport. (NB. - Citizens of Berbados who apply for passports in Barbados ‘must produce the Barbados Identification Card grevidence of registration ifthe card is not available) ‘Applicaton for a separate passport for a chid under "8 should be made on Fom {) If chldren under 18 are to be included in @ passport, thelr Bith Certificate must be produced, CERTIFICATION OF APPLICATION. The apalication ‘must be coritiod and sponsored in Section 12 by tne Passport Officer, any Member of Pariament, Magistrate, Jestice of the Peace, Ministr of Religion, Police Officer (Gazetted Rank), Bank Manager, Medical Practitioner, Lawyer, School Principal or Senior Civil Servant who has been previously acquainted with the applicant. (2) All married women must produce thei martiage certicates| (6) Chiléren between ine ages of 18 and18 years of age may not be ranted passports without the written consent of the parent ‘except where the person under 18 is marred. Section 9 may be completed jin reference to (e) above a separate letter is acceptable, The relationship to te child should be stated in ether case (0.9. father, mothe, brother, etc.) 3. PHOTOGRAPHS. Twocopies of a recent photograph ofthe applicant must be included withthe application, ‘Those must be takon fullface, without hat, on a white background and must not be mounted. The size ‘must not be mace than § centimetres by 5 centimetres The person who certifies the application Is also required to endorse the reverse side of one copy withthe words: “I certty that this is a true wnge of name-ciher hen ky mariage Dr edopon mis photograph of the applicant Mr. (Mrs. oF Miss) ee cis ic cossuteoaesabsita on aaa i substantisted by the production of evidence showing that a bona ‘ide change has been made for all purposes. ‘The orginal name isnot required in cases of adoption. (NB. = Any person claiming legal custody during the lifetime of the parents, must produce the court order commiting the child to that person's custody). ‘and ada hisiner signature. (Applicants abroad must iso submit 2photos), ‘Allphotographis included wit an application become the property ‘of the Government of Barbados when i is lodged.APPLICATION FORM “A” To avoid doy, ansuers to all relevant sections should be completed in nk in applicant's ovm handwriting. “There are good reasons fr this. Except n Ue case of physical disablily, fare to comply may lead to delay inthe issue of passpor. 41.| Sumame: (in block capita) PERSONAL DESCRIPTION (Stote whether Me Mrs. or Miss) po tess Chistian Names |r Orotner names (in fils Block capitals) ‘Cesupation ‘Age last" Place & County of Birth Date of Birth Residence (County) bithaay } Marital Status: ‘Single Maries ~—=«Widowed Divorced (ok aporopriatty) cl im] Oo o Hoioht Contneres Maiden name (applicant is weman who is or has been marred) Colour of eyes (uso biock capitals) | Has name been changed otherwise than by marrage? | colour of nat Iso, state orignal name (a bisek capitals) | Colour of air [See Note 4)! Ow «oO Present Address (in bock capitals) ‘Special Peculaties (Visible) Usual Piace of Residence (in block capitals) * If applicant is under 18 years of age, written consent of parent must be produced [See Note {f] 2 | TO BE COMPLETED BY PERSONS BORN ABROAD A Particulars of applicant’ fathermother [See Note 4(0)) I Place & county of fathers bth . Dato of father's birt Place & county of mother's bith Date of mother's bith I fatnerimother isa ctizen of Barbados by Natualsation or Registration, state — No.of Document Date of Issue Place of issue B Hf applicant's birth was registered at @ Barbados Consulate abroad state - "Name of Barbados Consulate Dale and No. of Repisvaton Certitcate | Place, county and date of fathers bith National Status (ick V appropiate) cmzen oF BarBanos =] byaitn C7 by Descent TC wy Naturaisation 7). by Registration by naturalisaton or registration, state ~ __ No of Document Date of Issue Place of Issuo ‘Sign name in each box along center of each box Below as inaicated by arrowsDOCUMENTS PRODUCED TO BE NOTED HERE (Tick appropriate box) rrorocree ‘Sony Sm) Aspleants 2 Psion Sed conte of Qo Birth Certificate a Photographs o Citizenship hi Ct arooe Ober Birth Certificate a Certificate o Documents. | [6] NExXTOF KIN > Name ssnsnnmnann ” Relationship... 7 ~ 7 Address. Contact No. APPLICANT'S SIGNATURE {Signin center of bax by arrow) CHILDREN UNDER 16 (io be includ in te passport) ‘Christian Namas or Other Names Place of 'S6x 6 Relation To th hl) Sumame a Date of Birt ant ‘NOTE: If applicant is not the parent, written consent of parents MUST be produced PARTICULARS OF PREVIOUS PASSPORT WHICH HAS BEEN LOST OR IS NOT AVAILABLE FOR PRESENT USE (See ote, Secion 11) No... ‘ssuedat on ‘Bearers fullname attime of issue. a 7 a Circumstances in which passport was lost or destroyed, or other reason for iis nonavalablty ~ Place and date of loss. ‘What measures were taken at the time to report loss ar oblan recovery? Has loss been reported tothe Police? 1.50, state wnere and when "certify that the above particulars are correct and undertake in the event of the passport coming again into my possession to return it to the Passport Office, Barbados, to a Barbados Consulate or to a Barbados High Commissioner's Office for Cancellation, 16M enn - a DatePARENTS CONSENT [See Note «{) on page 1 15 (00) eenme fhe (F8tonship) of (name(s)) hereby give my consent fr himvertthem (a) hold a passport, | o (©) tobe incudedin the passport o Signature 40] SUPPLEMENTARY INFORMATION NOTE: Do not sign this form unless you have read the notes on Page + 11) DECLARATION |, the undersigned, hereby apply forthe issue ofa passpor. | decare thatthe information given in this (to be competed ‘pplication is correct to the best of my knowledge and ballet, and that | have not lost te status of {and signed by a CGtzen of Barbados; nor renounced such Citizenship, | septeans) ‘And | further declare, ‘A that have not previously held or applied for a passport of any description, | Or —B__ that all previous passports granted to me have been surrendered, other than passport or travel ‘document No whichis now attached and that I have no other application for 8 — [passport since the attached passport or travel document was Issued {0m 08 rot spe. Signeture bate NOTE:~ If you have had a passport which has been lost, cross out A and B and complete section 8. fA CERTIFICATION (Sco Notes 2 and 3 on page 1) | oartty thatthe applicant has been known personally fo me for ‘of my knowledge and belief the facts stated on tis form are conect (state period) and that to te best ‘iat Stamp (any ‘Signature. Fullname in Block capitals ‘Occupation (see Note 2 on p990 1) ‘Adress Date ‘Applicants and porsons who countersign applicants (see Section 12) are warned that, should any statement made in connection with this application prove to be untrue, the consequences to them may be seriou IMPORTANT FOR OFFICIAL USE ONLY ‘Amount of Fee Paid Issue authorized by Chiol immigration Officer