Form 4-A - Declaration Of Recommender For Belize Passport Appplication printable pdf download

Form 4-A - Declaration Of Recommender For Belize Passport Appplication

Form 4 - A

[Regulation 7(1)]

DECLARATION OF RECOMMENDER

FOR BELIZE PASSPORT APPPLICATION

FOR PERSONS UNDER 16 YEARS

I, (Mr., Mrs., Miss) ________________________________ of ___________________________

[print full name of Recommender]

[insert full address]

______________________________________________________________________________

and currently employed as ______________________ hereby declare/certify that I have been

[profession]

acquainted with the child (Mr., Miss) _____________________________________________

[print full name of Child]

for the past ______________ through (Specify relationship) ____________________________

[number of years]

_____________________________________________________________________________;

[Group A – Justice of the Peace, Minister of Religion, Medical Practitioner, Notary Public, or Attorney-at-Law.]

and that the information provided in his/her Belize passport application is true and correct to the

best of my knowledge, information and belief.

Signature of Recommender: ______________________

Date:

______/_______/________

[day / month / year]

Mobile: _____________________

Tel Office/Work:

_____________________

Email:

_____________________

Form 4-A - Declaration Of Recommender For Belize Passport Appplication