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CBC-RLH6YQMQ-B4 Form

Sha registration form

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0% found this document useful (0 votes)

14 views1 page

CBC-RLH6YQMQ-B4 Form

Sha registration form

Uploaded by

juliuskyalo725

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as PDF, TXT or read online on Scribd

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OFFICE OF THE PRESIDENT

CIVIL REGISTRATION SERVICES

APPLICATION FOR A BIRTH CERTIFICATE
CBC-RLH6YQMQ

FORM B4 FEE: 250.0 DATE: SAT 17 MAY 2025

TO BE COMPLETED IN CAPITAL LETTERS FOR OFFICIAL USE ONLY

TYPE OF APPLICATION NEW WITHOUT AMENDMENT NOTIFICATION NUMBER 3864444

COUNTY OF BIRTH NAIROBI APPLICATION NUMBER

EXACT PLACE OF BIRTH NAIROBI WEST HOSPITAL PRINT DATE

NAME OF CHILD JOY MUMBE KYALO NAME OF REGISTERING OFFICER

CHILD ABOVE 18? NO RECORD CHECK BY

DATE OF BIRTH 12-12-2023 ASSESSED BY

SEX OF THE CHILD FEMALE APPROVED BY

ENTRY OR NOTIFICATION NUMBER 3864444

DETAILS OF FATHER AVAILABLE? YES

NAME OF THE FATHER JULIUS KYALO NGINE

ID NUMBER OF THE FATHER 31010863

DETAILS OF MOTHER AVAILABLE? YES

NAME OF THE MOTHER MUMBUA KIMONYI

ID NUMBER OF THE MOTHER 38849863

ADDRESS OF THE APPLICANT EMBAKASI

SIGNATURE

APPLICANTS NAME JULIUS KYALO NGINE TELEPHONE NO +254708498223

DATE PRESENTED SAT 17 MAY 2025 PICK UP LOCATION HUDUMA GPO

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CBC-RLH6YQMQ-B4 Form

Uploaded by

CBC-RLH6YQMQ-B4 Form

Uploaded by

OFFICE OF THE PRESIDENT

CIVIL REGISTRATION SERVICES

FORM B4 FEE: 250.0 DATE: SAT 17 MAY 2025

TO BE COMPLETED IN CAPITAL LETTERS FOR OFFICIAL USE ONLY

TYPE OF APPLICATION NEW WITHOUT AMENDMENT NOTIFICATION NUMBER 3864444

COUNTY OF BIRTH NAIROBI APPLICATION NUMBER

EXACT PLACE OF BIRTH NAIROBI WEST HOSPITAL PRINT DATE

NAME OF CHILD JOY MUMBE KYALO NAME OF REGISTERING OFFICER

CHILD ABOVE 18? NO RECORD CHECK BY

DATE OF BIRTH 12-12-2023 ASSESSED BY

SEX OF THE CHILD FEMALE APPROVED BY

ENTRY OR NOTIFICATION NUMBER 3864444

DETAILS OF FATHER AVAILABLE? YES

NAME OF THE FATHER JULIUS KYALO NGINE

ID NUMBER OF THE FATHER 31010863

DETAILS OF MOTHER AVAILABLE? YES

NAME OF THE MOTHER MUMBUA KIMONYI

ID NUMBER OF THE MOTHER 38849863

ADDRESS OF THE APPLICANT EMBAKASI

APPLICANTS NAME JULIUS KYALO NGINE TELEPHONE NO +254708498223

DATE PRESENTED SAT 17 MAY 2025 PICK UP LOCATION HUDUMA GPO

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