Kibanja Certificate Application

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Note: This form must be filled in quadruplet (4 copies). Fields marked with * are required.

A Registration Details

▼

Cell / Village *

Date of Registration *

Kibanja File Number *

B Kibanja Holder Personal Details

▼

Title *

Sex *

Nationality *

Surname *

First Name *

Middle Name

C Personal Identification Details

▼

Identification Type *

Identification Number / NIN *

Country of Issue *

Date of Issue *

Date of Expiry

D Communication Details

▼

Business Telephone

Home Telephone

Postal Address

Fax Number

E Residential Address

▼

Cell *

Parish *

County *

District *

F Next of Kin

▼

Title *

Sex *

Nationality *

Surname *

First Name *

Middle Name

Telephone No *

Relationship *

Address *

G Source of Income

▼

Employment Type *

Employer Name

Employer Location

Gross Monthly Income (UGX) *

H Payment Details (Application Fee)

▼

Payment Method *

Payment Date *

Receipt Number *

Amount Paid (UGX) *

I Kibanja Location Details

▼

Village *

Parish *

Sub-County *

County *

District *

Block *

Plot *

Acreage (Size) *

Date of Occupancy *

How You Came to Occupy *

Sketch Map *

Upload a clear image of the hand-drawn sketch map (JPG, PNG)

J Neighbors (Four Directions)

▼

In Front

Neighbor Name

Contact

Back Side

Neighbor Name

Contact

On the Left

Neighbor Name

Contact

On the Right

Neighbor Name

Contact

K Purpose & Ownership Type

▼

Purpose of Occupation *

Ownership Type *

Ownership Preference

Do you wish to own the Kibanja as Family?

Do you wish to own the Kibanja as Community?

Do you wish to own the Kibanja as an Individual?

L Application Signatures

▼

Applicant 1 Signature / Thumbprint *

Applicant 2 Signature / Thumbprint

Applicant 3 Signature / Thumbprint

Applicant 4 Signature / Thumbprint

Application Date *

By submitting this application, I/We confirm that all information provided is true and accurate.

Kibanja Certificate of Occupancy

A Registration Details

B Kibanja Holder Personal Details

C Personal Identification Details

D Communication Details

E Residential Address

F Next of Kin

G Source of Income

H Payment Details (Application Fee)

I Kibanja Location Details

J Neighbors (Four Directions)

K Purpose & Ownership Type

L Application Signatures