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V.

5 Edition January 2023


IFISHI 8.c
AMASEZERANO Y’IGABANA RY’UBUTAKA BW’UBUHINZI KU
BASANGIYE IBYANGOMBWA BY’UBUTAKA
Twebwe,
1. ………………………………………………………............
Ufite Indangamuntu nimero:

2. ………………………………………………………………
Ufite Indangamuntu nimero:

3. ………………………………………………………………
Ufite Indangamuntu nimero:

Hashingiwe ku kuba dusangiye ubutaka bw’ubuhinzi (mu migabane) ku butaka bwanditse kuri
UPI …/...../…../…./……. buherereye mu Karere ka …………, Umurenge wa …………, Akagari ka ………….,
Umudugudu wa ………….. kubera ko kubuganyamo ibice bitari byemewe;
Hashingiwe kandi ku ifishi z’ibipimo by’ubutaka bwapimwe hakurikije igice buri wese atunze biri ku mugereka;

Tugabanye ubutaka butwanditseho bubaruye kuri UPI .…/...../…../…../……. ku buryo bukurikira:

1. ………………………………… ufatanyije na ………………………………..barandikwa ku butaka


bubaruye ku ifishi y’ibipimo nomero ……….
2. ………………………………… ufatanyije na ………………………………..barandikwa ku butaka
bubaruye ku ifishi y’ibipimo nomero ……….
3. ………………………………… ufatanyije na ………………………………..barandikwa ku butaka
bubaruye ku ifishi y’ibipimo nomero ……….

Abagabanye ubutaka:

Amazina Umukono

1. …………………………………………………………. Umukono: …………………………….


2. …………………………………………………………. Umukono: …………………………….
3. …………………………………………………………. Umukono: …………………………….
4. …………………………………………………………. Umukono: …………………………….
Bikozwe kuwa ……/……/…………

Bikorewe imbere ya ……………………………………………………… Icyo ashinzwe: …………………………

Umukono na kashi……………………………

Icyitonderwa : Iyi nyandiko ishyirirwaho umukono imbere y’Ubuyobozi bw’Akagari, umukozi ushinzwe
ubutaka ku Murenge cyangwa mu Biro by’ubutaka mu Karere.

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