V.

05 Edition January 2023

IFISHI 27.b

IFISHI ISABA KUVANAHO UBURENGANZIRA KU BUTAKA BW’UNDI

BUKOMOKA KU MITERERE Y’AHANTU (SERVITUDE)
Umwirondoro w’utanga uburenganzira
Njyewe/Twebwe: .....…………………………………………………………………………………………………………………
Indangamuntu/Pasiporo: …………………..………………………………………………………………………………………
Aderesi: Akarere ka…………………….…. Umurenge wa ……………………………Akagari ka ……………………............
Umudugudu wa ………………................Telefoni : ………………………………………... E-mail: ……................……………...

Ndasaba kwandikisha uburenganzira ku butaka bukomoka ku miterere y’ahantu (servitude)

Amakuru ku butaka bugomba gutanga inzira

Nimero y'ikibanza/isambu (UPI): …………………………..................................
Umujyi wa Kigali/Intara: ………………………………………................
Akarere: …………………………………………………....
Umurenge: …………………………………….……………..
Akagari: …………………………………….……………..

Amakuru ku butaka bugomba guhabwa inzira

Nimero y'ikibanza/isambu (UPI): …………………………..................................
Umujyi wa Kigali/Intara: ………………………………………................
Akarere: …………………………………………………...
Umurenge: …………………………………….……………..
Akagari: …………………………………….……………..

Ibisobanuro k'ubusabe………………………………………………………………………………………….....................................
……………………………………………………………………………………………………………………………….....................................

Ibisabwa
Kopi y’ibiranga usaba
Amasezerano y’ubwumvikane hagati y’impande zombi yakorewe imbere y’ubuyobozi bw’Akagari
cyangwa icyemezo cy’ ubuyobozi bw’Akagari kivanaho uburenganzira ku butaka bw’undi
bukomoka ku miterere y’ahantu mu gihe impande zombi zananiwe kumvikana

…………………………….. ………………………………………………………………………………
Itariki y'ubusabe Umukonow'usaba (w'abasaba)

Byakiriwe kandi bisuzumwa na: ………………………………...................................................................................................

Icyo ashinzwe:……………………………………………………………………………………………………………………………..................................

Itariki: ………………………………………………………
Kashe
Umukono: …………………………………………………