Form 3

[Regulation 7(1)]
DECLARATION OF RECOMMENDER FOR BELIZE PASSPORT APPLICATION
FOR PERSONS 16 YEARS AND OVER

I, (Mr., Mrs., Miss) ____________________________________________________________ of

[print full name of Recommender]

____________________________________________________________________________________
[insert full address]

and currently employed as _______________________________ hereby declare/certify that I am a

[state profession or if retired]

Belizean by _________________________ and I have been personally acquainted with the applicant
[birth or descent]

(Mr., Mrs., Miss) _______________________________________ for the past ______________ years

[print full name of applicant] [number of years]

through _____________________________________________________________________; and that

[specify relationship]

the information provided in his/her Belize passport application with respect to identity, is true and correct

to the best of my knowledge, information and belief.

I understand that it is an offence under section 3(e) and (h) of the Passport Act, Chapter 164 of the Laws

of Belize, to make any false representation with respect to information requested by this form.

Signature of Recommender: ______________________

Date: ______/_______/_______
[day / month / year]

Tel Office/Work: _____________________

Mobile: _____________________

Email: _____________________

Recommender’s Passport Number: ____________________ Date of Issue: ______/_______/______

[day / month / year]

Documents to be Produced

A. Copy of machine readable Belize passport; and

B. Signed oath of accuracy on the application
C. $1.50 postage stamps

Rev. 2020.01 v1.0