"Bahamas Passport Application Form" - Bahamas

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BAHAMAS PASSPORT APPLICATION FORM
(To be completed in BOLD CAPS and Black or Blue Ink)
(For Official Use Only)
Application ID: ____________________
Ordinary/Regular
Child
Frequent Traveler
Certificate of Identity
Diplomatic
Official
p
p
p
p
p
p
First Time
Renewal
Damaged/Lost/Stolen
p
p
p
1. PERSONAL DETAILS:
Mr.
p
Mrs.
p
Ms.
p
Miss.
p
Dr.
p
Other ________________________
Surname
First Name
Middle Name(s)
Date of Birth
Maiden Surname
Place and Country of Birth
(DD/MM/YYYY)
Height
Colour of Eyes
Colour of Hair
Nationality
___________ ft. ___________ ins.
Visible Identification Marks (Please note in detail)
National Insurance No.
Sex
Male
Female
p
p
2. CONTACT DETAILS:
Present Address (Apt. No., P O Box, Street, City State & Country)
Permanent Address (Apt. No., P O Box, Street, City State & Country)
Telephone (Home & Work)
Email (Optional)
3. EMPLOYMENT DETAILS:
Occupation
Employer Name, Address, and Telephone ( If applicable)
4. FAMILY DETAILS:
Father’s Full Name (underline surname)
Country of Birth
Nationality
Date of Birth
(DD/MM/YYYY)
Mother’s Full Name (underline surname)
Country of Birth
Nationality
Date of Birth
(DD/MM/YYYY)
Spouse’s Full Name (underline surname)
Country of Birth
Nationality
Date of Birth
(DD/MM/YYYY)
Person to contact in case of an emergency
Name:
Address:
Relationship:
Telephone:
5. PASSPORT DETAILS
:
(only for previous passport holders)
Passport Number
Bearer’s name at time of issue of previous passport
Status of Passport
Date Lost/Stolen
Place (Island/State/County/Province) &
(DD/MM/YYYY)
Expired
Pages Full
Name Change
Country where lost/stolen
p
p
p
Damaged
Stolen
Lost
p
p
p
Has loss been
Yes
No
Police Station & Date of Report
Police Report
Yes
No
Reported to Police?
p
p
Submitted
p
p
BAHAMAS PASSPORT APPLICATION FORM
(To be completed in BOLD CAPS and Black or Blue Ink)
(For Official Use Only)
Application ID: ____________________
Ordinary/Regular
Child
Frequent Traveler
Certificate of Identity
Diplomatic
Official
p
p
p
p
p
p
First Time
Renewal
Damaged/Lost/Stolen
p
p
p
1. PERSONAL DETAILS:
Mr.
p
Mrs.
p
Ms.
p
Miss.
p
Dr.
p
Other ________________________
Surname
First Name
Middle Name(s)
Date of Birth
Maiden Surname
Place and Country of Birth
(DD/MM/YYYY)
Height
Colour of Eyes
Colour of Hair
Nationality
___________ ft. ___________ ins.
Visible Identification Marks (Please note in detail)
National Insurance No.
Sex
Male
Female
p
p
2. CONTACT DETAILS:
Present Address (Apt. No., P O Box, Street, City State & Country)
Permanent Address (Apt. No., P O Box, Street, City State & Country)
Telephone (Home & Work)
Email (Optional)
3. EMPLOYMENT DETAILS:
Occupation
Employer Name, Address, and Telephone ( If applicable)
4. FAMILY DETAILS:
Father’s Full Name (underline surname)
Country of Birth
Nationality
Date of Birth
(DD/MM/YYYY)
Mother’s Full Name (underline surname)
Country of Birth
Nationality
Date of Birth
(DD/MM/YYYY)
Spouse’s Full Name (underline surname)
Country of Birth
Nationality
Date of Birth
(DD/MM/YYYY)
Person to contact in case of an emergency
Name:
Address:
Relationship:
Telephone:
5. PASSPORT DETAILS
:
(only for previous passport holders)
Passport Number
Bearer’s name at time of issue of previous passport
Status of Passport
Date Lost/Stolen
Place (Island/State/County/Province) &
(DD/MM/YYYY)
Expired
Pages Full
Name Change
Country where lost/stolen
p
p
p
Damaged
Stolen
Lost
p
p
p
Has loss been
Yes
No
Police Station & Date of Report
Police Report
Yes
No
Reported to Police?
p
p
Submitted
p
p
BAHAMAS PASSPORT APPLICATION FORM
(To be completed in BOLD CAPS and Black or Blue Ink)
6. ADDITIONAL DETAILS:
Applicant a Citizen of the Bahamas by:
Document Number
Birth
Registration
Naturalization
Date of Document Issue
Place of Document Issue
(DD/MM/YYYY)
p
p
p
What other names have you used? (list all alias)
Applicant a Citizen of the Bahamas by:
Marriage
Adoption
Poll Deed
1 ____________________________________
2 ____________________________________
p
p
p
Other: _____________________________
3 ____________________________________
4 ____________________________________
7. TO BE COMPLETED IF PERSONS BORN ABROAD:
Mother is a Citizen of the Bahamas by:
Document Number
Birth
Registration
Naturalization
Place of Document Issue
Date of Document Issue
(DD/MM/YYYY)
p
p
p
Document Number
Father is a Citizen of the Bahamas by:
Birth
Registration
Naturalization
Place of Document Issue
Date of Document Issue
(DD/MM/YYYY)
p
p
p
If applicant’s birth was registered at a Bahamian Consulate abroad, state the city
Registration Certificate Number
where the Consulate is located.
Date of Registration
(DD/MM/YYYY)
8. TO BE COMPLETED IF CHILD IS UNDER AGE 18:
Full Name (mother, if unmarried, either parent, if married or legal guardian)
Relationship to Child
Present Address (including country)
I hereby give my consent for (name of applicant) to be
issued a passport
Signature
Date
(DD/MM/YYYY)
9. DECLARATION OF APPLICANT:
I, the undersigned, hereby apply for the issue of a passport. I declare that the information given in this application is correct to the best of my
knowledge and belief, that I have the status of Bahamian citizen, and that I have not renounced citizenship of The Bahamas. I further declare that:
p
I have not previously held or applied for a passport of any description.
p
All previous passports granted to me have been surrendered, other than passport of document No. ____________________________
which is now attached, and that I have submitted no other application for a passport since the attached passport or travel document
was issued to me.
Signature:__________________________________________________________
Date:_____________________________________
10. COUNTERSIGNATURE
:
(Required for First Time and Lost or Stolen Applications only)
Full Name (please print)
Profession
OFFICE STAMP
Present Address (including country)
I certify that the applicant has been known personally to me for _____________ years and that
to the best of my knowledge and belief the facts stated on this form are correct. I am a citizen of
_________________________ and I was born at ____________________________________
Signature
Date
(DD/MM/YYYY)
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