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The Public Authority for Civil Information

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The Public Authority for Civil Information

Declaration of the picture authenticity

Declaration Number

Information about the concerned person: Civil Number

Sex Nationality - - - - - - ­

I Declaration J

I am the undersigned, I declare that all information in this application are correct,
and the photograph above is for the person concerned. I also note that in a case
of manipulation \ will be accused of forgery crime in ofncial papers . The
punishment for this crime may be up to seven years in prison, and or a fine of
amount up to five hundred Kuwaiti Dinar, as it is stated in article 259 in penal law.
Beside that. it is also considered as a crime of presenting incorrect information to
the public authority for civil information. The punishment for this oct may be up to
six months in prison, and or a fine of up 0 five hundred Kuwaiti Dinar, as it is stated
in article 35 of law number 32/82 concerning the civil information system.

Name: . . _ Civil Number; . ._ _

Relation to the concerned person: Signature:

Date: 1_1__

Official Use
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1- The in charge employee of taking the application:

Name: Signature: -- .- -.---., , - - - Date: --1-1 _ _

2- Revision Appro\'al :

Name: _ Signature: "._.. _ Date: 1_ L _

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