6/2/2020                                                                                   COVID-19 Permits
Movement Permits
                       DECLARATION FORM OF EXCEPTIONAL MOVEMENT OF PERSONS DURING STATE OF PUBLIC EMERGENCY
                                                             (reg. 7(1))
                                                  FOR ENQUIRIES, PLEASE CALL THE COVID-19 CALL CENTRE AT 16649
                                                        IN CASE OF MEDICAL EMERGENCIES PLEASE CALL 997
       Applicant Details                                                                      HOME                              GOV Portal
           Surname*                                                                             First, Middle names*
            Sankoloba                                                                            Chingani
                                                                                                                                 Gender*
           Identity Number*                            Nationality*                             Date Of Birth*
            Identity Number                             Nationality                              DD/MM/yyyy                          Male     Female
           Identity number is required.                                                                                          Gender is required
           Cell Phone 1*                               Cell Phone 2
                      71 123 456                                 71 123 456                     Email Address                        Plot Number*
                                                                                                 Email Address                        Plot Number Address
           District/Area*
           Select district                             Village/Town/Locality*
                                                       Select Village/City/Town                 Locality/Ward*
                                                                                                 Location/Ward
       Household Characteristics
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                                                                                                       Other (Please describe)
                 Multiple Houses                                Private Toilet
                  Single House                                   Shared Toilet
            Select housing arrangement                     Select toilet arrangements
        Contact Details of Household Members
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                               Surname*                                First, Middle Names*                     Cell Number
                 X              Surname                                 First, Middle Names                      Cell Number
                               Surname*                                First, Middle Names*                     Cell Number
                 X              Surname                                 First, Middle Names                      Cell Number
           Travel Details*Blue Permit
           valid for 5 days
           Reason*                                                    Purpose
                                                                              of Travel*                                  Destination
                                                                                                                                      Zone*
            reason
https://covid19.gov.bw/apply/essential/informal                                                                                                                 1/2
6/2/2020                                                            COVID-19 Permits
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               Destination
            Departure Location
              District/Area*
              Select District/Area                Village/Town/Locality*
                                                  Select Village/City/Town                      Departure   Zone*
                                                                                                Select Village/City/Town
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https://covid19.gov.bw/apply/essential/informal                                                                            2/2