THE UNITED REPUBLIC OF TANZANIA NO.
250526O3582-B
REGISTRATION INSOLVENCY AND TRUSTEESHIP AGENCY (RITA)
APPLICATION FOR NEW BIRTH CERTIFICATE
(BIRTHS AND DEATHS REGISTRATION ACT)
(CAP 108)
CHILD PERSONAL INFORMATION
FIRST NAME HUSNA MIDDLE NAME JUMA
SURNAME RAMADHANI OTHER NAMES --
DATE OF BIRTH 30-OCT-2007 SEX FEMALE
MOBILE NO 0697380630 EMAIL --
OCCUPATION STUDENT NATIONALITY TANZANIA
EDUCATION LEVEL SECONDARY EDUCATION PHYSICAL ADDRESS KIPUNGUNI
ENTRY NO --
CHILD PLACE OF BIRTH CHILD PLACE OF DOMICILE
COUNTRY OF BIRTH TANZANIA COUNTRY OF DOMICILE TANZANIA
REGION OF BIRTH KIGOMA REGION OF DOMICILE DAR ES SALAAM
DISTRICT OF BIRTH UVINZA DISTRICT OF DOMICILE ILALA
WARD OF BIRTH ILAGALA WARD OF DOMICILE UKONGA
STREET OF BIRTH MACHAZO STREET OF DOMICILE KIPUNGUNI B
BIRTH INFORMATION
PLACE OF BIRTH HOME TYPE OF BIRTH TWINS
HOSPITAL NAME -- BIRTH NOTIFICATION --
WEIGHT AT BIRTH 2 PRESENT DURING TRADITIONAL BIRTH DELIVERY
DELIVERY
MOTHER'S PERSONAL INFORMATION
FIRST NAME SADA MIDDLE NAME MOSHI
SURNAME SHOMARI OTHER NAMES --
DATE OF BIRTH 03-MAR-1972 SEX FEMALE
MOBILE NO 0763007672 EMAIL --
ID TYPE NOT AVAILABLE ID NO --
OCCUPATION DOMESTIC WORKER(KAZI ZA NYUMBANI) NATIONALITY TANZANIA
IDENTIFICATION TYPE NOT AVAILABLE IDENTIFICATION NO --
NIN / NIDA -- ENTRY NO --
IS ALIVE YES PHYSICAL ADDRESS ILAGALA
MOTHER'S PLACE OF BIRTH MOTHERS'S PLACE OF DOMICILE
COUNTRY OF BIRTH TANZANIA COUNTRY OF DOMICILE TANZANIA
STREET ILAGALA REGION OF DOMICILE KIGOMA
DISTRICT OF DOMICILE UVINZA
WARD OF DOMICILE ILAGALA
MOTHER'S PREGNANCY INFORMATION
NO OF PREGNANCY -- NO OF CHILDREN --
NO OF SAFE DELIVERIES -- MONTH OF PREGNANCY --
DEATHS BEFORE DELIVERY --
FATHER'S PERSONAL INFORMATION
FIRST NAME JUMA MIDDLE NAME RAMADHANI
SURNAME ALLY OTHER NAMES --
DATE OF BIRTH 18-SEP-1968 SEX MALE
MOBILE NO 0763007672 EMAIL --
ID TYPE NOT AVAILABLE ID NO --
OCCUPATION OTHER NATIONALITY TANZANIA
NIN -- ENTRY NO --
IS ALIVE NO PHYSICAL ADDRESS MACHAZO
FATHER'S PLACE OF BIRTH FATHER'S PLACE OF DOMICILE
COUNTRY OF BIRTH TANZANIA COUNTRY OF DOMICILE TANZANIA
STREET ILAGALA REGION OF DOMICILE KIGOMA
DISTRICT OF DOMICILE UVINZA
WARD OF DOMICILE UVINZA
INFORMANT'S PERSONAL INFORMATION
FIRST NAME HUSNA MIDDLE NAME JUMA
SURNAME RAMADHANI OTHER NAMES --
DATE OF BIRTH 30-OCT-2007 SEX FEMALE
MOBILE NO 0697380630 EMAIL --
ID TYPE NOT AVAILABLE ID NO --
OCCUPATION STUDENT NATIONALITY TANZANIA
NIN -- ENTRY NO --
PHYSICAL ADDRESS KIPUNGUNI
INFORMANT'S PLACE OF BIRTH INFORMANT'S PLACE OF DOMICILE
COUNTRY OF BIRTH TANZANIA COUNTRY OF DOMICILE TANZANIA
STREET KIPUNGUNI B REGION OF DOMICILE DAR ES SALAAM
DISTRICT OF DOMICILE ILALA
WARD OF DOMICILE UKONGA
ACCOUNT DETAILS PAYMENT DETAILS
ACCOUNT EMAIL ESTERMATEI704@[Link] CONTROL NUMBER 991387633922
ACCOUNT MOBILE NO 0652620440 AMOUNT 20,000.00
PAYMENT STATUS PAID
KIAPO: NATHIBITISHA KUWA MAELEZO NILIYOTOA HAPO JUU NI SAHIHI KWA KADIRI YA UFAHAMU WANGU NA NINAVYOAMINI
(ONYO: UNAKUMBUSHWA KWAMBA KIFUNGU CHA 29 (3) LA SHERIA YA KUANDIKISHA VIZAZI NA VIFO LIMEWEKA ADHABU KWA MAKOSA YA KUTOA TAARIFA ZA
UONGO)
SIGNATURE DATE OF APPLICATION MAY 26, 2025
TAARIFA ZA MSAJILI
MIMI
MSAJILI WA VIZAZI NA VIFO (W) NIMEPOKEA MAELEZO YA MWOMBAJI CHINI YA KIAPO KWA
MAMLAKA NILIYOPEWA CHINI YA KIFUNGU CHA 20(2) SURA YA 108 LEO HII
SAINI YA MSAJILI TAREHE YA USAILI
