:i.:t-J.-II ~ J.

tlAoU 40 lAJ I ~ I
The Public Authority for Civil Information

e~~
~~II.i~~ '-'~~IJ o~J ~ JI.,i!

.J \ .;-9,} I ~.J

1111111111111111111111111111111111111111111111111111111
581567016

~I ---- _.- ... ~I

(JI; ;!>
0J~I U~J ' tj~1 I~ o,)JI.,...Ji ":'W~I
~ cw;i ~,.....ll wi ..>--Ji
.. i~;> 1 I .Jl.;.-J,! I I L ~U Ul> .j G~ ~ ~ .. U':!-UI ~u ;;J>-D..r ~'j..s. i
o J L..J.. '---! ! ,~l c ~ L.....l. I ~ y..J I , j I J ~ I .j J'--:! j ~ I W: J-?' ..,....i> oj J..S-.L.: .:.LJ ~ u!---i •
LIj-lJ wl~ ~ jju_~..3'l' o..u ~ JI ~ ~ _La....:; ..;-JI J <Ij-JI u~L.j tJ-.o '1'0'1.
..r---i: ,,:, L..-,j ~ • 'I.>'! I W:J-?' ~ .:.LJ j U~ 0-> "j.".Aj • ~ y.S I J ~ J U l...c.......J.. U J ..u
U~ "'I'/n p--.J) U~LLlI 0-A fo o,)UL.,> .Jj...1l j ~.J....l1 ":'Lo~1 p.L.h...i..J ~
LAI ~j ~i ~ ~ ..l..-:!j.....3'l ~..u ~ . ~ -,WL.....l.1 j ~.L.l1 ":'Lo~1 p.L...l:W
~y.S I J~,) UL....c....J- j j 4-J..-,J'i

.".......i-Ll 1 ~;-J' : f>-"l1 1

: ~..rJ...J1 J-ill
.
~j
I...l.J I

II II

~)
. I...l.J I

.
~J
L.l.J I
,. ....

~.Io6II.:.iIo~ ~1AJ1 ~I
The Public Authority for Civil Information

Declaration of the picture authenticity

to be approved in the civil ID

Declaration Number

Information about the concerned person: Civil Number

Name:

Sex Nationality - - - - - - ­

I Declaration J

I am the undersigned, I declare that all information in this application are correct,
and the photograph above is for the person concerned. I also note that in a case
of manipulation \ will be accused of forgery crime in ofncial papers . The
punishment for this crime may be up to seven years in prison, and or a fine of
amount up to five hundred Kuwaiti Dinar, as it is stated in article 259 in penal law.
Beside that. it is also considered as a crime of presenting incorrect information to
the public authority for civil information. The punishment for this oct may be up to
six months in prison, and or a fine of up 0 five hundred Kuwaiti Dinar, as it is stated
in article 35 of law number 32/82 concerning the civil information system.

Name: . . _ Civil Number; . ._ _

Relation to the concerned person: Signature:

Date: 1_1__

Official Use
III til

1- The in charge employee of taking the application:

Name: Signature: -- .- -.---., , - - - Date: --1-1 _ _

2- Revision Appro\'al :

Name: _ Signature: "._.. _ Date: 1_ L _

..