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Application Form 2a Nida

This document is a registration form for Tanzania's national identification system. It collects personal details such as name, date of birth, nationality, phone number, gender, marital status, occupation, parents' details, residential and permanent addresses, identification documents, and applicant declaration. The applicant must provide their signature and date, and the form includes spaces for signatures from local government, immigration, registration, and national identification authorities to verify the application information.

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optatiussabas1988
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1K views

Application Form 2a Nida

This document is a registration form for Tanzania's national identification system. It collects personal details such as name, date of birth, nationality, phone number, gender, marital status, occupation, parents' details, residential and permanent addresses, identification documents, and applicant declaration. The applicant must provide their signature and date, and the form includes spaces for signatures from local government, immigration, registration, and national identification authorities to verify the application information.

Uploaded by

optatiussabas1988
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REF: Registration Form No: 2A

BATCH NUMBER:
POSTCODE:
VILLAGE / MTAA / SHEHIA:
ENROLLMENT STATION: THE UNITED REPUBLIC OF TANZANIA
BATCH DATE: D D M M M Y Y Y Y MINISTRY OF HOME AFFAIRS

2A
NATIONAL IDENTIFICATION AUTHORITY

IDENTIFICATION FORM
(THIS FORM MUST BE FILLED IN BY LEGAL RESIDENTS/ REFUGEES)

Put a Tick Mark ( ) in the relevant box LEGAL RESIDENT REFUGEE


A: PERSONAL DETAILS:

1. FIRST NAME

2. MIDDLE NAME

3. SURNAME

4. OTHER NAMES

5. DATE OF BIRTH D D M M Y Y Y Y

6. PLACE OF BIRTH

7. NATIONALITY

8. PHONE NUMBER

9. GENDER MALE FEMALE

10. MARITAL STATUS: SINGLE MARRIED WIDOW / WIDOWER DIVORCED

11. OCCUPATION: EMPLOYEED SELF EMPLOYEED UNEMPLOYEED

B: PARENTS / GUARDIAN DETAILS:

12. FATHER’S FIRST NAME

13. FATHER’S MIDDLE NAME

14. FATHER’S LAST NAME

15. MOTHER’S FIRST NAME

16. MOTHER’S MIDDLE NAME

17. MOTHER’S LAST NAME

C: RESIDENTIAL ADDRESS IN TANZANIA:

18. HOUSE NUMBER

19. REGION

20. DISTRICT

21. WARD

22. VILLAGE / MTAA / SHEHIA

23. STREET/ KITONGOJI

24. POSTAL ADDRESS

25. POSTCODE

Version No. 1.1


D: APPLICANT’S PERMANENT ADDRESS:

26. COUNTRY

27. ADDRESS LINE 1:

28. ADDRESS LINE 2:

29. ADDRESS LINE 3:

30. ADDRESS LINE 4:

31. ADDRESS LINE 5:

E: PERSONAL REFERENCES
( Tick ( ) if Attached )

32. PASSPORT NUMBER 32.

33. PASSPORT EXPIRY DATE D D M M Y Y Y Y

34. RESIDENT PERMIT / EXEMPTION CERTIFICATE / DEPENDANT PASS NUMBER 34.

35. RESIDENT PERMIT / EXEMPTION CERTIFICATE / DEPENDANT PASS EXPIRY DATE D D M M Y Y Y Y

36. WORK / AUTHORITY PERMIT NUMBER 36.

37. WORK / AUTHORITY PERMIT EXPIRY DATE D D M M Y Y Y Y

38. REFUGEE ID CARD NO / RATION CARD NO. 38.

39. REFUGEE ID CARD NO / RATION CARD EXPIRY DATE. D D M M Y Y Y Y

40. CONVETION TRAVEL DOC NO / CERTIFICATE OF IDENTITY NO. 40.

41. CONVETION TRAVEL DOC NO / CERTIFICATE OF IDENTITY EXPIRY DATE. D D M M Y Y Y Y

F: APPLICANT’S DECLARATION
I verify that all the information I have given above is correct and true to the best of my knowledge and belief.

42. APPLICANT’S SIGNATURE 43. LGA OFFICER’S NAME AND SIGNATURE .


E
UR
AT
IGN
E N DS
T UR MEA
NA NA
SIG CE
R’S
’S FI
NT OF
CA A
PLI LG
AP

DATE D D M M Y Y Y Y DATE D D M M Y Y Y Y

G: FOR OFFICIAL USE ONLY.

44. CENTER NUMBER 45. REGION

46. DISTRICT

47. WARD

48. CENTER NAME

49. APPLICATION DATE D D M M Y Y Y Y

50. REGISTRATION OFFICER’S NAME

51. IMIMIGRATION OFFICER’S NAME AND SIGNATURE 52. RITA / RGO OFFICER’S NAME AND SIGNATURE 53. WEO / EMPLOYER’S NAME AND SIGNATURE 54. NIDA OFFICER’S NAME AND SIGNATURE

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