54 [Subsidiary] CAP. 172 Immigration Form 13 [Rev. 2010 (r. 23) INTERSTATE PASS [Page 1] This interstate pass entitles the holder thereof to re-enter Kenya from Tanzania or Uganda at any time and on any number of occasions within the period of validity of this pass. [Page 2] This pass is valid until ..................... day of ................................. 19........... Date .................................. .................................................... Principal Immigration Officer [Page 3] Full names of holder ........................................................................................... ............................................................................................................................. Full address in Kenya ......................................................................................... ............................................................................................................................. Occupation ........................................................................................................ [Page 4] Unmounted photograph of holder .............................................. Signature of Holder [Page 5] 1st Renewal The period of validity of this pass is extended until ......................................... ............................................................................................................................ Date........................... ...................................................... Signature of Renewing Officer