STATE OF ORIGIN / LOCAL GOVERMENT

ATTESTATION FORM
(APPLICATION FOR ADMISSION INTO THE 76th REGULAR
COURSE)
Nigerian Defence Academy Kaduna

JAMB Reg. Nuumber: 202441581290AF

Candidate's Name: SAMSON SUGHNEN ABOH
Residential Address: BADARIYA AREA, BIRNIN KEBBI, KEBBI STATE
State of Origin: Benue
Faculty: Faculty of Science
Course of Study: BSc Biology
Date of Birth: 30-08-2005
Choice of Service: NIGERIAN ARMY/NIGERIAN NAVY

ATTESTATION OF LOCAL GOVERNMENT AREA OF ORIGIN

To be completed by Chairman or Secretary of the Local Government Area of your State or any
military officer of the rank of Lieutenant Colonel (or equivalent) and above who hails from your
state. Parent/Guardians will not sign for their sons/daughters/wards but must ensure that this
form is completed.

Rank/Position (of Endorsing officer)___________________________________

Service No:_________________ LGA:_____________________________
I certify that _________________________________________ hails from _________________________Local
Government Area of_____________ State.
Name:_____________________________ Signature/Stamp_______________
Date:_______________________