GOVERNMENT OF KIRIBATI MINISTRY OF JUSTICE PHOTO

P.O. Box 62 Telegram: MOJ Telephone: (686) 75022801, 75022802, 75022809 Email: nic@justice.gov.kiFB Page: Ministry of Justice

Bairiki, Tarawa, Republic of Kiribati

NATIONAL ID CARD REGISTRATION APPLICATION

New ID Card (3yrs validity) Renewal of ID Card ($10.00 - Expired,lost,damaged)

Male Female(DD-MM-YY)

(Ward/District)

7. Gender:

9. Place of Birth:

11. Citizenship type:

13. Phone no:

(Prior Statutory declaration , Marriage or Adoption)

The Confidentiality and Nondisclosure of Applicant Information is protected under The National Identity Registration Act 2018 (Section 24)

8. Abode of Resident:(AM TABO NI MAEKA)

10. Home Island:

12. Email Address:

1. Purpose of Application

2. Given name:

3. Surname/Father’s name:

4. Mother's names:

5. Other name(s):

6. Date of Birth:

(ARAM)

(AM KAUOUA N ARA/TAMAM)

(ARAN TINAM)

(ARAM RIKI TABEUA)

(AM BONG NI BUNG)

KC NC RCC RCL(ABAM)

(BUKIN KANOAKIN TE FORM)

I declare that the foregoing information I have provided on this application is true and correct to the best of my knowledge.

Applicant's Signature (Taiaoka Tiaaina inanon te baoki)

_____________________ Today's date

(DD/MM/YY)

OFFICIAL USE ONLY

______/________/_______ (DD/MM/YY)

Date:

PIN:

NID no:(Naturalization ID number, for Naturalized & Registered Citizens only applying for I-Kiribati citizenship)

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