Rev. 2010] Immigration CAP. 172 FIRST SCHEDULE—(Contd.) [Subsidiary] Form 4—(Contd.) 5. .......................................... relationship to holder ......................................... 6. ........................................... relationship to holder ........................................ Date of issue......................................... ..................................................... Receipt number............................ Principal Immigration Officer Note.–The holder must enter Kenya within six months from the date of issue. _____________ Form 5 45 (r. 12) [Page 1] NOTICE OF APPEAL (To be completed in duplicate) To: The Minister Responsible for Immigration, Thro’ The Principal Immigration Officer, Department of Immigration, Nairobi, Kenya. Names of Appellant Address of Appellant ................................................ ............................................ ................................................ ............................................ ................................................ ............................................ Date.................................... SIR, The Principal Immigration Officer has advised me in his letter No. R................. dated ............................. of his decision to refuse my application for an Entry Permit under Class .... of the Schedule to the Immigration Act, and I wish to appeal against this decision. My full particulars are as follows: (a) Full name ..................................................................................... (b) Type of pass or permit now held ................................................. ……………………………………...………......……………….