A brief biodata of imam of .

Mosque,
.. Village, Village Track,
Under Sector 5, Camp 12, Rwak Nyo Taung
1.
2.
3.
4.
5.
6.
7.
8.
9.

Name: ..
Another Name: ..
Date of Birth:
Race/ Religion:
ID card No: ...
Qualification: ..
Place of Birth: ..
Profession: .
Current Address: ..
..
10. Fathers
a. Name: . b. Profession:
c. Address:
11. Mothers
a. Name: . b. Profession:
c. Address:
12. Wifes
a. Name: . b. Profession:
c. Address:
13. Political party involved
..
14. Name and address of the mosque serving currently
.
Signature: ..
Name: ..

Form (2)
Inspectees statement
A brief biodata: ........
.
.
.

1. Name:
2. Fathers name:
3. Mothers name:
4. ID Card No.:
5. Date and Place of Birth:
6. Gender:
7. Race / Religion:
8. Profession:
9. Previous Address:
10. Current Address:
11. Date and Place of inspection:
I am stating correctly as follows.

1. I was born in Sector/ Village, Town,

and have transferred to .
Sector/ Village Track,
.. Village with/without special transfer permission called Form
(10). I have been living together with (
) family member until year (
).
2. I have been living both in previous and current address with legal/illegal family
list issued by Immigration department related to sector/ village.
3. (
) member of my family hold / dont hold Citizenship Card/ National ID
Card/ Temporary ID Card issued by the Immigration. I, the guardian, am/am
not able to show documents to the responsible while inquiring.
4. Confession regarding crime

.
.

After being explained to me in understood language, I admit to be true and

sign below.

Inspectees statement
In my presence,
Inspector

Inspectee

Signature

Signature

Name

Position

Witness (1)

Witness (2)

Signature

Signature

Name

Name

ID No.

ID No.

Address

Address