Rev. 2010]
CAP. 172
Immigration
FIRST SCHEDULE—(Contd.)
Form 12—(Contd.)
4. Particulars of any valid permit or pass issued to the applicant .....................
............................................................................................................................
..............................................................................................................................
.............................................................................................................................
5. Particulars of profession, business, employment or other calling which
necessitates the applicant’s travelling within the East African States .................
..............................................................................................................................
..............................................................................................................................
.............................................................................................................................
.............................................................................................................................
6. Number of anticipated journeys per
annum
Tanzania .........................................
Uganda ...........................................
7. Particulars of any previous interstate pass issued to the applicant .................
.............................................................................................................................
I ...................................................., the applicant, declare that the foregoing
particulars are correct in every detail.
Date ..................................
....................................................
Signature of Applicant
(Do not send any money with this application)
Note.–This application must be accompanied by–
(a) two unmounted photographs not exceeding two inches by three
inches in dimension (not required in the case of an extension);
and
(b) any previous interstate pass in the possession of the applicant.
*Delete whichever is inapplicable.
For Official Use Only
Interstate Pass No. .............................................................................................
Issued on ..........................................................................................................
Valid/Renewed until ..........................................................................................
Date........................................
___________
Signed............................
53
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