Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698831595268.pdf (Saint Kitts and Nevis)
To avoid delay answers to relevant sections should be completed in black or blue ink.

1 a) Applicant'sSignature: Please sign below within the area bounded by the marks.

r b) ApplicantsPhotograph: Supplied photos must cover the marks below.

__l _l L- b) Application for: [ ]Adult [ ] Child underAge 16 Please fill out the form in BLOCK CAPITALS.

NOTE: Do not sign this form until you have read all notes on page 1.
Application Number Passport Number 2 Surname Given Names: [ ]Mr [ ]Mrs [ ]Ms [ ]Miss Status: Single Manied Widowed Divorced Legally Separated Maiden Name: (if applicant is a woman who is or has been married) Has name been changed otherwise than by marriage?
t I No lf so, state original name [ ]Yes Gender: [ ]Male I jFemale PERSONAL DESCRIPTION Age last birthday Place and country of birth Date of Birth Height: Feet Inches Occupation: Present address: Colour of eyes Colour of hair Usual place of residence: Special peculiarities (visible) Contact numbers: J CITIZENSHIP CitlzenofSt.KittsandNevisby [ ]Birth [ ]Descent [ ]Marriage [ ]Residence [ ]Registration [ ]tnvestment lf born in [ ] St. Kitts [ ] Nevis Birth Certificate no.
.. Parish lf born outside of St. Kitts and Nevis, particulars of Certificate of Citizenship/Registration Number of Certificate Date of lssue ... ... ... .

.. 2 4 PERSONS WH O ARE CITIZENS OF SAINT CHRISTOPHER (ST. KITTS) AND.-NEVIS BY DESCENT Name of parenUgrandparent that was born in St. Kitts and Nevis Place of Birth Date of Birth 5 PERSO NS WHO ARE CITIZENS OF SAINT CHRTSTOPHER (ST. KITTS) AND NEVTS By M.ARR|AGE ONLY lf spouse was born outside of the Federation, certificate of citizenship number: ... .
.. .

Place of Marriage Date of Marriage ... .

.. 6 PASSPORT REQUIRED FOR TRAVELLING TO 7 I PURPOSE OF TRAVEL THIS SECTION IS TO BE COMPLETED BY THE PARENT OR LEGAL GUARDIAN OF A CHILD UNDER AGE 16 DECLARATION |'theundersigned,herebyapplyforthe|ssueofapassporttotheabove-namedchild.ldeclarethatthe information gye!

jn this application is correct to the besi of my knowledge and belief, anrj that the child has not lost the status of cttizen of Saint Christopher (St. Kitts) and Nevis.
I further declare fcross out "A" or "B", whichever does not apply): A - that the child has not previously held or applied for a passport of any description; B - that all previous passports granted to the child have been surrendered, otherthan passport ortravel document No..................... which is now attached, and that no other application for a passport has been made since tiie aitached passport or travel document was issued to him/her.

Name ..........
Signed Relationship to Child Date NOTE: lf the child has had a passport which has been lost, cross out A and B and complete the passport Recovery Form THIS SECTION IS TO BE COMPLETED BY APPLICANT OVER AGE ,I6 l, the undersigned, declare that the information given in the application is correct and a. that I have not lost the status of Citizenship of Saint Christopher (St. Kitts) and Nevis b. that I have not previously held or applied for any passport or c' that all previous passports granted to me have been cancelled other than passport no.
.............. that I have not made any other application for a passport since the attached passport was issued to me.

which is now attached and d. that I understand that knowingly making a false statement in this application is an offence contrary to section 10 of the passports and Travel Documents Act Signature Date J I Recommender I certify that the applicant is known to me personally and that to the best of my knowledge and belief, the facts stated on this form are correct.
I have known the applicant for .. .

.

years' Official stamp Signature..... .. Full name.......

Occupation ...

., Address.........

Date ...

IMpoRTANT:- Applicants and persons who countersign applications (see section 7) are warned that, should any statement made in connection with this applicani prove to be untrue, the consequences to them may be serious 10 FOR OFFICIAL USE DOCUMENTS SUBMITTED TO BE NOTED HERE SUPPLEMENTARY INFORMATION 4