OFFICE OF THE PRESIDENT

CIVIL REGISTRATION SERVICES

APPLICATION FOR A BIRTH CERTIFICATE
CBC-PYHKVL5Y

FORM B4 FEE: 180 DATE: WED 29 MAY 2024

TO BE COMPLETED IN CAPITAL LETTERS FOR OFFICIAL USE ONLY

TYPE OF APPLICATION NEW NOTIFICATION NUMBER 4005009

COUNTY OF BIRTH NAIROBI APPLICATION NUMBER

EXACT PLACE OF BIRTH KASARANI MATERNITY PRINT DATE

NAME OF CHILD GIANNA NJERI KAMAU NAME OF REGISTERING OFFICER

CHILD ABOVE 18? NO RECORD CHECK BY

DATE OF BIRTH 27-03-2024 ASSESSED BY

SEX OF THE CHILD FEMALE APPROVED BY

ENTRY OR NOTIFICATION NUMBER

DETAILS OF FATHER AVAILABLE? YES

NAME OF THE FATHER DANSON KAMAU MWANGI

ID NUMBER OF THE FATHER 26765002

DETAILS OF MOTHER AVAILABLE? YES

NAME OF THE MOTHER MARY WAMBUI MAINA

ID NUMBER OF THE MOTHER 31882726

NAME OF THE GUARDIAN

ID NUMBER OF THE GUARDIAN

ADDRESS OF THE APPLICANT GITHURAI

SIGNATURE

APPLICANTS NAME MARY WAMBUI MAINA TELEPHONE NO +254743970154

DATE PRESENTED WED 29 MAY 2024 PICK UP LOCATION ACK BISHOP