Edition May 2018

FORM 2
INYANDIKO ISABA GUHUZA UBUTAKA
Umwirondoro
Njyewe/Twebwe: .....…………………………………………………………………………………………………………………...........
Irangamimerere: …………………………….…………………………………………………………………..........................................
Indangamuntu/Pasiporo: …………………..………………………………………………………………………………………..........
Aderesi: Akarere ka…………………….…. Umurenge wa ……………………………Akagari ka ……………………............
Umudugudu wa ……………….............Telefoni :………………………………... E-mail:…………………………………….........

Cyangwa
Isosiyete/ONG/Ishyirahamwe ry’umwuga/Idini/Koperative/Ibindi…………………………………………….........
Njyewe (Uhagarariye mu buryo bwemewe n'amategeko):………………………………….............................................
Indangamuntu/Pasiporo: ……......………………………………………………………………………………………………………..
Aderesi: Akarere ka…………………….…. Umurenge wa ……………………………Akagari ka ……………………............
Umudugudu wa ………………................Telefoni: ……………………………….. E-mail: .........................................................

Ndasaba guhuza ibibanza/amasambu

Amakuru ku kibanza/Isambu
Nimero y'ikibanza/isambu (UPI): 1)…………… 2)..................... 3)................
Umujyi wa Kigali/Intara: ………………………………………................
Akarere: ………………………………………………….
Umurenge: …………………………………….…………….
Akagari: …………………………………….…………….

Ibisobanuro k'ubusabe………………………………………………………………………………………….....................................
……………………………………………………………………………………………………………………………….....................................
……………………………………………………………………………………………………………………………….....................................

Ibisabwa

Ibyangombwa by’ubutaka busabirwa guhuzwa1

…………………………….. ………………………………………………………………………………
Itariki y'ubusabe Umukono w'usaba (w'abasaba)

Byakiriwe kandi bisuzumwa na: ………………………………...................................................................................................

Icyo ashinzwe:……………………………………………………………………………………………………………………………..................................

Itariki: ………………………………………………………
Kashe
Umukono: …………………………………………………

1 Bitewe n’imitungire y’ubutaka, ibyangombwa by’ubutaka bishobora kuba kimwe muri ibi bikurikira:
 Amasezerano y’ubukode burambye, icyemezo cy’iyandikisha ry’ubukode bw’igihe kirekire n’ igishushanyo cyerekana ingano y’ubutaka
 Icyemezo cy’inkondabutaka
 Icyemezo cy’Iyandikisha ry’Impapurompamo ngenankomyi,
 Icyemezo cy’iyandikisha ry’ibice by’isangiramutungo ku nyubako