Belize Passport Application For Persons 16 Years And Over Page 3
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_____________________________________________________________________
FOR OFFICIAL USE ONLY
Form accepted by ____________________
Date _____/_____/_____NEW PASSPORT NUMBER
(day/month/year)
____________________________
Documents Submitted
Applicant’s
Applicant’s
Applicant’s
Marriage
Social Security
Other
Birth Certificate
Previous
nationality
Certificate
/ Voter’s ID
Documents
passport
certificate
e.g. deed poll
No.:
No.:
No.:
No.:
No.:
District:
Place of Issue:
Place of Issue:
Place of issue:
Date of Issue:
Date of Issue:
Date of Issue:
Date of Issue:
Date of issue:
Date of
Registration:
Cashier ______________________
RCR Date _____/_____/_____
RCR No.: ________________
Amount: $______________
Counter Supervisor _____________ Data Entry _________________ OIC Approval _____________
Print Operator ___________
QA _________________ Passport Delivered by (Signature) _________________
(Print Name) _____________________________
Passport Received by: (Signature) ________________ (Print Name) _____________________________
Date _____/_____/_____
(day/month/year)
BELIZE PASSPORT APPLICATION INSTRUCTIONS
1.
THIS FORM SHOULD BE CLEARLY WRITTEN IN PRINT WITH BLACK OR BLUE INK.
2.
SECTIONS 1 AND 4 OF THIS FORM MUST BE COMPLETED BY ALL APPLICANTS.
3.
SECTIONS 2 AND 3 MUST BE COMPLETED BY THOSE TO WHOM THEY APPLY.
4.
THE OFFICIAL LANGUAGE IS ENGLISH AND ALL DOCUMENTS SUBMITTED MUST EITHER BE IN
ENGLISH OR BE ACCOMPANIED BY A CERTIFIED ENGLISH TRANSLATION OF THAT DOCUMENT.
Authentication of Application
The application form must be authenticated and sponsored in FORM 3A by (GROUP A) a Justice of the Peace, Minister
of Religion, Medical Practitioner, Notary Public, or Attorney at Law.
The application form must be authenticated and sponsored in FORM 3B by (GROUP B) a Member of the House of
Representatives, Chief Executive Officer in any Ministry of the Government of Belize, Head of Department of any
Department of the Government of Belize, or a Licensed Teacher.
Documents to be Produced
If the applicant is:
A.
a Belizean by birth (born in Belize) - birth certificate from the Registrar General’s office (for those applying for the
first time and those replacing lost, destroyed, or stolen passports); previous passport (for those
replacing/renewing available passports.)
B.
a Belizean by descent [born outside Belize to Belizean parent(s) but naturalized - (i) birth certificate from native
country and (ii) his/her naturalization by descent document or other evidence of Belizean nationality.
C.
a Belizean by registration (born outside Belize but has become a citizen through naturalization) - (i) native birth
certificate or passport and (ii) his/her Belize nationality certificate.
D.
a married woman – all of the above that apply plus a marriage certificate (issued by vital statistics or registrar’s
office.)
E.
a divorced woman wishing to revert to her maiden name – all of the above that apply plus the divorce certificate.
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