REPUBLIC OF KENYA

IN THE MATTER OF: THE OATHS AND STATUTORY DECLARATIONS ACT CAP 15
LAWS OF KENYA
AND
IN THE MATTER OF SELINA NASUBA (DECEASED)

AFFIDAVIT
I, ERIC SHISYUBU ISALAMBO of ID Number 27802759 a resident of MOMBASA in the
Republic of Kenya do hereby make oath and solemnly state as follows: -

1. THAT I am an adult male Kenyan citizen of sound mind and the holder of Kenyan
National Identity Card No. 27802759. Annexed hereto and marked “ESI-1” is a copy
thereof.

2. THAT the deceased SELINA NASUBA is my friend and I was the next of kin during
their admission.

3. THAT I now wish to be allowed to obtain the body in my name for purposes of burial of
the deceased.

4. THAT I have obtained the necessary consent of the family from the sister ROSE
NAMALWA to the deceased.

5. THAT the cause of death of the deceased is known to us and we do not wish to have a
postmortem.

6. THAT what is deponed to herein is true to the best of my knowledge, information and
belief and in accordance with the Oaths and Statutory Declaration Act, Cap 15 of the
Laws of Kenya.

SWORN at MOMBASA this day of 2024.

By the said ERIC SHISYUBU ISALAMBO ___________________

Before me: DEPONENT

COMMISSIONER FOR OATHS.