Dominica

FORM A COMMONWEALTH OF DOMINICA APPLICATION FOR A PASSPORT AND INSTRUCTIONS ON HOW TO COMPLETE
(Surname)

(Maiden name) Second name) (Third name)

(First name)

IMPORTANT: Read instructions carefully before completing the form. Note: Amendments cannot be made to Passports NOTE: - Where an Order or direction has been made by the High Court or in Chambers or by a Magistrate regarding the custody of a child, ( A) All applicants (Male or Female) must complete Sections 1, 2, such Order must be produced and the nature of the direction stated. and 7, and if applicable, Section 4. (iv) Change of Name. An applicant, who has changed his or her (B) Married women (including widows and women whose marriages name, must submit the Deed Poll and a Birth Certificate showing such change have been dissolved) must also, in addition to (A) above, complete Section 3. and particulars of the Deed Poll. (C) A passport application for a child under 16 years, must be made by or with the notarized consent of the parent, adoptive parent or Legal Guardian by completing Sections 1, 2, 6, and 7, if applicable Section 4. (D) Signing the form. The applicant must sign section 7 and signature box. Children 10 years and above must sign signature box. (Signature box must not be signed on behalf of children). Thumb prints will be taken for adults unable to sign. (E) Recommender: Section 8 should be completed by the person (the recommender) verifying the declaration who must be a member of Parliament, a Mayor or City Councillor or Village Council Chairperson, Justice of the Peace, Minister of Religion, Staff Nurse and above, Medical or Legal Practitioner, Established Civil Servant (Executive Officer and above), Senior Bank Official. Police Officer of the rank of Sergeant and above, Qualified Teacher and above, Custom Officer Grade 1 and above, Principal Prison Officer and above, business manager or any person of' similar standing personally acquainted with the applicant. The recommender must be a...